Medicaid provides a safety net for those in need in Georgia. The system helps good people in a medical situation that is beyond their financial means.

Paperwork, government bureaucracy and innocent mistakes are among the obstacles you may face when applying for this service. Protect yourself by studying and understanding the Medicaid process.

Why you might face denial

Medicaid covers a wide range of Georgia residents. You must meet income eligibility requirements. You also must belong to an eligible group:

  • Women who are pregnant and their child
  • Children under age 19
  • Residents over age 65
  • The legally blind
  • The disabled
  • People needing nursing home care

Missing financial documentation may undermine your Medicaid application. These can range from bank statements to tax returns.

Always be as thorough as possible. The information must be clear to the person reviewing your case. It is important to avoid giving the appearance that you are hiding something.

Your behavior may also lead to denial. If you move your assets to meet income guidelines, you face rejection.

How to appeal

The state must send you a written notice of denial. The notice explains the reasoning behind the rejection. It also outlines your right to file an appeal.

File a written request for a hearing, paying strict attention to state deadlines. The state will send you a hearing notice. You must attend the hearing. Missing the hearing means you lose.

Prepare yourself for the hearing. Start by requesting a copy of the state file on your case. Understand how the state sees your case. This may help you plan your arguments for a reversal.

Your best chance for a successful appeal

You can make your best effort and still lose your case. The Medicaid application and appeal processes are overwhelming, but may also be an important part of planning for long-term care. You may overlook or misunderstand the rules. It’s easy to make an innocent mistake without some help on your side.