Appealing the Denial or Limitation of Medicaid Benefits

When are Medicaid Appeals necessary? You have completed a Medicaid Application and filed it with the State and are shocked when you receive a Notice of Decision advising you that you or your loved one has been denied the requested Medicaid payment of the cost of the Nursing Home or that a period of ineligibility has been assessed against you. Many people initially apply for Medicaid by themselves or with the assistance of someone at an agency or nursing home.  Frequently the individual assisting you does not actually understand application process, the procedural rules or are unaware of changes in the law. This can result in the application being denied or approved but subject to an improper penalty period during which Medicaid will not pay. If that happens, unless an immediate Appeal is filed, the Nursing Home will expect the family to pay out of their own funds or will begin Involuntary Discharge action against the resident.  In addition, under the terms of many Nursing Home Contracts, the agent under a Durable Power of Attorney or other responsible party might be liable.  the family   and you are expected to pay. You don’t know what you did wrong or what to do now.  If this happens to you, the Law Office of James C. Siebert & Associates, P.C. /Elder Law & Estate Planning Attorneys of Illinois, P.C. can represent you in an Appeal of the Medicaid Denial, but only if you act immediately.  Call the Law Office of James C. Siebert & Associates, P.C. /Elder Law & Estate Planning Attorneys of Illinois, P.C. at (847)253-7500 today to schedule an appointment with an experienced Elder Law Attorney to discuss your options.

In addition State caseworkers who review the Medicaid applications frequently make mistakes, misinterpret or misapply the administrative rules and policies which cam also result in denials or approvals subject to incorrect penalties or limitations of benefits. The Law Office of James C. Siebert & Associates, P.C. /Elder Law & Estate Planning Attorneys of Illinois, P.C. has extensive experience in the preparation and submittal of Client’s Medicaid Applications, and therefore can frequently step in and determine the cause of the adverse decision and assist in the legal and procedural steps necessary to reverse the denial or limitation of benefits.

Denied stamp (2) 640 x 609The  Law Office of James C. Siebert & Associates, P.C. /Elder Law & Estate Planning Attorneys of Illinois, P.C. understands that the filing and After completing the extensive application, assembling five years’ worth of financial information and doing everything reasonably requested by the State to achieve eligibility, you are frustrated by the demands by the State to provide additional documentation or information and yet you cannot get the State to answer your simple questions. If this has happened to you, you are not alone. The Medicaid system in Illinois is designed to frustrate, delay and then deny applications. It appears that because of the State’s financial issues and an unwillingness to raise taxes to support necessary programs for the disabled and elderly, that Illinois has decided to make the Medicaid application process complicated and difficult enough so that when the State denies or limits benefits under a Medicaid application the people will either walk away, accept the improper penalty and pay out of the children’s retirement or grandchildren’s college funds, thus saving Illinois the funds necessary to provide long term care for its elderly residents who legitimately qualify.

Appeal points 1 2 3 640 x 426The Law Office of James C. Siebert & Associates, P.C. /Elder Law & Estate Planning Attorneys of Illinois, P.C. has successfully handled numerous appeals and has extensive experience in this process. The Office has been retained by many individuals whose applications have been denied to file an appeal on their behalf, sometimes the individuals being referred to the Law Office of James C. Siebert & Associates, P.C. /Elder Law & Estate Planning Attorneys of Illinois, P.C. by the Nursing Facility as at that point it is in both the individual and the facility’s interest to get the denial reversed. If you or your loved one’s application has been denied or approved subject to incorrect penalties or limitations of benefits then call the Law Office of James C. Siebert & Associates, P.C. /Elder Law & Estate Planning Attorneys of Illinois, P.C.  immediately to schedule an appointment to review your options.

PLEASE REMEMBER THAT WITH A MEDICAID DENIAL OR ADVERSE DECISION OF ANY TYPE YOU HAVE AN EXTREMELY LIMITED AMOUNT OF TIME TO TAKE THE NECESSARY STEPS TO APPEAL THE DECISION AND THEREFORE THE LAW OFFICE OF JAMES C. SIEBERT & ASSOCIATES, P.C./ ELDER LAW & ESTATE PLANNING ATTORNEYS OF ILLINOIS, P.C.  STRONGLY URGES YOU TO IMMEDIATELY UPON RECEIPT OF THE NOTICE TO CALL AND MEET WITH AN EXPERIENCED ELDER LAW ATTORNEY TO PROTECT YOUR INTEREST, THEREFORE CONTACT THE LAW OFFICE OF JAMES C. SIEBERT & ASSOCIATES, P.C./ ELDER LAW & ESTATE PLANNING ATTORNEYS OF ILLINOIS, P.C. OR GO TO THE ILLINOIS CHAPTER OF THE NATIONAL ACADEMY OF ELDER LAW ATTORNEY’S WEBSITE AT http://www.naela-il.org TO FIND A QUALIFIED ELDER LAW ATTORNEY IN YOUR AREA.


Client Testimonials  

  • We were so pleased that you were able to get this matter resolved for us. We truly appreciate all of your hard work and effort on our behalf. I believe you went over and beyond to get everything resolved and I am so glad that you were a determined man. You represent us well.

    Michael and Nancy W

  • Darlene and I would like to thank you and all the help you have been giving us. I don’t know how we would have been without it.

    Mary Lou W.

  • How would you rate Mr. Siebert’s legal expertise? A He is very knowledgeable of working or elder’s case law. James services were delivered in a timely basis. After we had phone the office with questions, our called were answered the same day. The staff was always courteous and polite.

    Karen G.

  • I was excited to have such an honest and well versed attorney with your inter personal skills and expertise. I needed an elder law attorney who was proficient, honest and who could work with the bureaucrats involved with the Medicaid process. I can honestly say that I was so glad I met with and hired you.

    Sandra D.

  • I am writing to recommend the services of James C. Siebert, Attorney at Law. He is very knowledgeable in elder law issues and can be relied upon to offer the best advice possible

    Barbara B.




 
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