- Special Needs Alliance - https://www.specialneedsalliance.org -

Appealing Medicaid And SSI Decisions: Know Your Rights

By Ann N. Butenhof, CELA [1] & Judith L. Bomster, Esq. [2]

Medicaid and SSI (Supplemental Security Income) are often essential to quality of life for individuals with disabilities. So it can be very stressful if benefits are denied, decreased or terminated [3]. But federal law guarantees the right to appeal if you think a mistake has been made. And while there are strict procedures to follow, appeals are often successful.

Medicaid Appeals

Medicaid is a joint federal/ state initiative, with each state defining and managing its own plan in accordance with national requirements. Though eligibility requirements vary by state, certain aspects of the appeals process are uniform across the U.S.:

Supplemental Security Income Appeals

SSI is a federal cash assistance program for individuals meeting the Social Security Administration’s (SSA) definition of disability, as well as income and asset guidelines. In most states, SSI eligibility automatically qualifies an individual for Medicaid, but that is not true in every state.

The appeal process can become very complicated, and in some cases, legal counsel is advisable. Members of the Special Needs Alliance are well versed in the intricacies of both Medicaid and SSI, and can assist you in determining your best course of action.