how do i get lawyer when i'm on medicaid

by Viva Hegmann 5 min read

The short and simple answer is no, a lawyer is not needed to get Medicaid. However, based on one’s marital status, financial holdings, and complexity of other relevant factors, it may be best to hire an attorney who specializes in Medicaid in the state in which one resides.

Full Answer

Do I need a lawyer to get Medicaid?

Mar 22, 2022 · The short and simple answer is no, a lawyer is not needed to get Medicaid. However, based on one’s marital status, financial holdings, and complexity of other relevant factors, it may be best to hire an attorney who specializes in …

How do I apply for Medicaid if I have a disability?

A Medicaid lawyer is a legal professional who specializes in the complex laws of the Medicaid program. A Medicaid lawyer assists eligible people who have been denied coverage in obtaining their legal rights to Medicaid benefits. Medicaid lawyers intervene on a client’s behalf by filing an appeal to review a denial of benefits. A Medicaid lawyer may also file an appeal if a Medicaid …

What does a Medicaid attorney do for seniors?

Find a local Medicare And Medicaid attorney in your state. Our client reviews, law firm profiles, and live chat make it easy to find the best Medicare And Medicaid lawyer for you.

How do I apply for Medicaid or chip?

Sep 13, 2019 · Talk with attorney Andrew M. Lamkin, P.C., today about your Medicaid application. He has helped countless seniors and their families apply for Medicaid, protect assets, and follow all laws so that they can unlock coverage for nursing home care. Schedule a free case evaluation now by calling 516-605-0625 or requesting an appointment online.

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What is a medicaid lawyer?

A Medicaid lawyer is a legal professional who specializes in the complex laws of the Medicaid program. A Medicaid lawyer assists eligible people who have been denied coverage in obtaining their legal rights to Medicaid benefits.

Who is eligible for medicaid?

Medicaid is the federal program that provides healthcare benefits to a wide variety of people including uninsured individuals with low income, pregnant women, certain children and disabled individuals, and senior citizens who need nursing home care. However, in order to receive Medicaid benefits individuals must meet financial eligibility ...

Do you have to meet financial eligibility requirements for medicaid?

However, in order to receive Medicaid benefits individuals must meet financial eligibility requirements. Medicaid benefits and eligibility requirements are even more complex because each state manages its own Medicaid program while the federal government sets Medicaid policies and contributes money to the state Medicaid fund.

Do you need a lawyer for medicaid?

Medicaid recipients are not the only people who need the services of a Medicaid lawyer. Oftentimes the legal guardian of a child or the caregiver for an elder must act on their behalf to obtain Medicaid benefits or handle other Medicaid problems.

Can a lawyer file an appeal for medicaid?

A Medicaid lawyer may also file an appeal if a Medicaid application is stalled in the system and has not been reviewed in a timely fashion. A Medicaid recipient may have trouble with the care and services received from a health organization authorized to provide Medicaid services.

Is Medicaid a bureaucracy?

Medicaid is a bureaucracy that is a partnership between the federal and state governments with services provided by huge healthcare corporations. It’s easy to understand how mistakes, delays and denials can occur.

What income is considered when applying for medicaid?

Your income, including any retirement, pension, and SSI income that you receive is considered when you apply for Medicaid. Your assets also play a crucial role in eligibility.

How to protect assets before applying for medicaid?

Before you file your application, sit down with a Medicaid attorney who can help review your assets, income, and see where you might be vulnerable. You may be able to protect some assets before you apply, and it is critical you know what rights you have and legal options to protect those assets. Failing to follow legal transfer rules could violate government regulations – something you do not want to toy around with when trying to get healthcare coverage from the government.

What is Medicaid coverage?

Medicaid is the single largest source of health coverage in the United States. To participate in Medicaid, federal law requires states to cover certain groups of individuals. Low-income families, qualified pregnant women and children, and individuals receiving Supplemental Security Income (SSI) are examples of mandatory eligibility groups (PDF, ...

What is Medicaid Spousal Impoverishment?

Spousal Impoverishment : Protects the spouse of a Medicaid applicant or beneficiary who needs coverage for long-term services and supports (LTSS), in either an institution or a home or other community-based setting, from becoming impoverished in order for the spouse in need of LTSS to attain Medicaid coverage for such services.

What is dual eligible for Medicare?

Eligibility for the Medicare Savings Programs, through which Medicaid pays Medicare premiums, deductibles, and/or coinsurance costs for beneficiaries eligible for both programs (often referred to as dual eligibles) is determined using SSI methodologies..

What is MAGI for Medicaid?

MAGI is the basis for determining Medicaid income eligibility for most children, pregnant women, parents, and adults. The MAGI-based methodology considers taxable income and tax filing relationships to determine financial eligibility for Medicaid. MAGI replaced the former process for calculating Medicaid eligibility, ...

How long does medicaid last?

Benefits also may be covered retroactively for up to three months prior to the month of application, if the individual would have been eligible during that period had he or she applied. Coverage generally stops at the end of the month in which a person no longer meets the requirements for eligibility.

How many people are covered by medicaid?

Medicaid is a joint federal and state program that, together with the Children’s Health Insurance Program (CHIP), provides health coverage to over 72.5 million Americans, including children, pregnant women, parents, seniors, and individuals with disabilities. Medicaid is the single largest source of health coverage in the United States.

Does Medicaid require income?

Certain Medicaid eligibility groups do not require a determination of income by the Medicaid agency. This coverage may be based on enrollment in another program, such as SSI or the breast and cervical cancer treatment and prevention program.

Reasons for Getting SSDI and SSI

People look to SSDI if they have a medical condition that prevents them from working. The actual eligibility requirements are:

Medicaid and Medicare Eligibility

Although both programs provide medical benefits, the programs differ in some significant areas.

Disability and Medicaid or Medicare

People who receive SSDI benefits are also able to get Medicare after a 24-month waiting period. It is also possible to qualify for Medicaid.

Get the Benefits You Deserve When You Need Them

Talk to a lawyer to find out if you are eligible for more than SSDI and SSI.

What is the number to call for Medicaid in NYC?

Those living in the five boroughs of NYC, whose cases are administered by the Human Resources Administration (HRA) office can call the HRA Infoline at 1 (718) 557-1399 or the HRA Medicaid Helpline at 1 (888) 692-6116.

Who is covered by medicaid?

Medicaid provides health coverage to eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.

What happens if you are enrolled in managed care in a new county?

If you are currently enrolled in a managed care plan that is not offered in the new county, your local department of social services will notify you so that you can choose a new plan. If your Medicaid is with the Marketplace, (NY State of Health), it is important that you update your account with your new address.

Do you have to apply for medicaid if you are 65?

You may be required to apply for Medicare as a condition of eligibility for Medicaid. Medicare is a federal health insurance program for people age 65 and for certain people with disabilities, regardless of income. When a person has both Medicare and Medicaid, Medicare pays first and Medicaid pays second.

How to get a baby card in New York?

To request a card for your unborn baby, you will need to contact your local department of social services or if your case is with the Marketplace, (NY State or Health), at 1 (855) 355-5777 and notify them that you are pregnant and what your anticipated due date is .

When does Medicaid recover from your estate?

If you receive medical services paid for by Medicaid on or after your 55th birthday , or when permanently residing in a medical institution, Medicaid may recover the amount of the cost of these services from the assets in your estate upon your death.

When is the new age for medicaid?

New Requirement for Medicaid Effective November 2017. If you are turning age 65 within the next three months or you are age 65 or older, you may be entitled to additional medical benefits through the Medicare program. You may be required to apply for Medicare as a condition of eligibility for Medicaid.

What is Medicaid and CHIP?

How to Apply for Medicaid and CHIP. Medicaid is a federal and state health insurance program for people with a low income. The Children’s Health Insurance Program (CHIP) offers health coverage to children.

What is BHP in Medicaid?

Learn how to use your Medicaid or CHIP coverage. Like Medicaid and CHIP, the Basic Health Program (BHP) offers affordable, continuous coverage. It’s an optional program that your state may offer. It’s available to people with incomes that shift above and below Medicaid or CHIP levels.

What age can a child get Medicaid?

It covers medical and dental care for uninsured children and teens up to age 19.

How to apply for CHIP?

You have two ways to apply for CHIP: Find a program by state, or call the Health Insurance Marketplace at 1-800-318-2596 (TTY: 1-855-889-4325 ). Fill out an application through the Health Insurance Marketplace.

Who is eligible for medicaid?

Medicaid provides free or low-cost medical benefits to eligible: Adults with a low income. Children. Pregnant women. People who are age 65 or over. People with disabilities.

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Determining Eligibility For Medicaid

  • Financial Eligibility
    The Affordable Care Act established a new methodology for determining income eligibility for Medicaid, which is based on Modified Adjusted Gross Income (MAGI). MAGI is used to determine financial eligibility for Medicaid, CHIP, and premium tax credits and cost sharing reductions avail…
  • Non-Financial Eligibility
    To be eligible for Medicaid, individuals must also meet certain non-financial eligibility criteria. Medicaid beneficiaries generally must be residents of the state in which they are receiving Medicaid. They must be either citizens of the United States or certain qualified non-citizens, suc…
See more on medicaid.gov

Medically Needy

  • States have the option to establish a “medically needy program” for individuals with significant health needs whose income is too high to otherwise qualify for Medicaid under other eligibility groups. Medically needy individuals can still become eligible by “spending down” the amount of income that is above a state's medically needy income standard. Individuals spend down by incu…
See more on medicaid.gov

Appeals

  • States must provide individuals the opportunity to request a fair hearing regarding a denial, an action taken by the state agency that he or she believes was erroneous, or if the state has not acted with reasonable promptness. States have options for how to structure their appeals processes. Appeals may be conducted by the Medicaid agency or delegated to the Exchange or …
See more on medicaid.gov

Related Topics

  • Spousal Impoverishment: Protects the spouse of a Medicaid applicant or beneficiary who needs coverage for long-term services and supports (LTSS), in either an institution or a home or other community-based setting, from becoming impoverished in order for the spouse in need of LTSS to attain Medicaid coverage for such services. Treatment of Trusts: When an individual, his or her s…
See more on medicaid.gov