Medicaid is a privilege that allows Americans access to medication and professional healthcare every year. Certain individuals can be denied, leaving them no other alternative but to seek third-party assistance.

Medicaid lawyers assist individuals deemed as ineligible but meet the criteria to be approved. Lawyers file appeals to get the denied individual a hearing that results in approval.

Why Would Someone Need a Medicaid Lawyer?

There are multiple reasons why an individual would need to obtain the services of a Medicaid lawyer.

Few people plan for long-term care and medical expenses that exist later in life. However, the majority of healthcare expenses exist for a person after they have already retired or are no longer able to work. Without the proper benefits, there exists no other way to pay for medical treatment other than Medicaid or private insurance.

The lack of a full-time income or savings makes private insurance out of the question, which leaves seniors with no other choice but to rely on the services of Medicaid.

When someone is denied Medicaid coverage, the services of a Medicaid attorney become extremely crucial. There are multiple reasons why a Medicaid lawyer can file an appeal for an individual that has been denied. Grounds for appeal include, but are not limited to the following reasons:

·         Medicaid eligibility

·         Determining someone is above the income limit

·         Denial of prior authorization for a wheelchair

·         Reduced allowance of care hours

·         No response when you need prior authorization approval

·         Denial of important medication

·         Determining you are no longer disabled

Attorneys can represent the interests of individuals that already receive Medicaid benefits. Items from the above list, such as the reduced allowance of care hours, no response for prior authorization, and denial of medication, are all services a Medicaid recipient would need.

When a new applicant is denied Medicaid altogether, the applicant must first file the appeal in the allotted time. This gives them the amount of time needed to secure a Medicaid attorney to take their case. If an applicant does not make the deadline, they will be required to start the process from the beginning.

When the attorney is retained, they will work with applicants by reviewing the denied application. The first step taken is ensuring everything on the application was filled out properly. Its possible mistakes were made that led to the denial of coverage.

Assuming everything was answered correctly, the next step would be to review the reasons for the denial. It’s possible the review board was incorrect in its reason for denial. The attorney will highlight this in the appeal, most likely leading to a reversal of the decision.

Suppose neither of these can be used to obtain a reversal. In that case, the attorney will work with the client to ensure they meet the criteria for approval. This includes being more clear on things like wages, living conditions, and medical issues. Attorneys always ensure fair treatment of all clients that retain their services.

Timely Reviews

In certain cases, applicants may submit their paperwork, expecting to receive an answer within the given window. However, sometimes applications are stalled for various reasons, significantly increasing the time it takes for an answer. Attorneys will also step in and file an appeal if the review hasn’t been completed promptly.

Fair and Equal

One of the most important services a Medicaid attorney provides is the oversight of the process to ensure a fair review takes place. Newcomers to the Medicaid process may be overwhelmed because of how unfamiliar they are with the approval or appeal process. The expertise of these attorneys is priceless in these situations to ensure the applicant is treated equally and fairly.

Does such a wide range of services have an effect on the final cost of a Medicaid attorney?

How Much Are the Services of a Medicaid Attorney?

The cost of a Medicaid attorney varies greatly from state to state. Several factors influence the final cost of these services. The size of the city and population numbers could have a minor effect. 

The specific services requested by a client will be the biggest driving factor regarding the final price. Appealing prior authorization decisions, income limits, and care hours will cost less than a full appeal for a brand-new applicant. New applicants will need an all-inclusive service instead of just a single area of interest like the ones mentioned above.

Normally attorneys bill clients on a per-hour or per-service basis, so the more comprehensive the service is, the higher the final charge will be.

The average cost of a Medicaid attorney spans a very large window. Final prices can fall anywhere between $3,000 and $10,000. Some areas have reported costs of up to $15,000, but these are rare cases.

Many times Medicaid cases are being reviewed as part of a disability or social security case. The applicant applying for disability of SSI will also expect to receive Medicaid as part of their benefits package. In these cases, many attorneys will take the case with no charge up front. The attorney’s compensation will be taken out of the back pay once the applicant has been approved for compensation. However, it should be noted this can substantially increase the amount the attorney would normally charge.

Whenever a substantial amount of money is paid for ensuring a favorable outcome, it’s important to be sure a seasoned professional is handling the proceedings.

Best Medicaid Attorneys in New York

Marshall Dennehey Warner Coleman & Goggin

88 Pine Street 21st Floor New York, NY 10005

212-376-6400

Epstein Becker & Green, P.C.

875 3rd Ave, New York, NY 10022

212-351-4500

Abrams, Fensterman, Fensterman, Eisman, Formato, Ferrara, Wolf & Carone LLP

1 MetroTech Center Suite 1701, Brooklyn, NY 11201

718-215-5300

Moskowitz Legal Group

1318 42nd Street Brooklyn, NY 11219

1200 West Broadway, Suite. 3 Hewlett, New York 11557

212-419-0118

Melnik Law Group, PLLC

3072 Brighton 1st St, Brooklyn, NY 11235

800-517-5110

If you’re in any of the areas listed above and are handling a Medicaid issue, it’s important you contact one of the attorneys listed above. They can assist individuals already receiving Medicaid and believe they have been wrongfully denied certain requests and services they need. 

These attorneys are also prepared to take on a complete appeal case. If you’re a newly denied applicant, they will review your case and find suitable grounds for appeal to get you the coverage you deserve.

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