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carolsmith1 Asked December 2018

Medicaid approval question; any experience with an appeal?

Hi ! Wondering if anyone has any advice. The lawyer is not being helpful. Applied for Medicaid for dad in NJ thankfully it was finally approved. Applied in July and they are paying from Oct 1st. There is also a 5k payment they are considering a gift. My sister moved from California for almost a year to take care of him and they are calling it a gift. My question is. Is it worth it to have the lawyer appeal it at a hearing? The 5k is ok if that slides but there are 3 months that we paid for his assisted living we were told we’d get back. Lawyer said anything from the Medicaid pending date would be reimbursed. Apparently not so. Worth it to appeal? This involves another 1 k to lawyer. Advice? Thanks!

vegaslady Dec 2018
Only worth it if you can find a way to show that the 5k wasn't a gift but necessary for that person to have a caregiver there. You don't need a lawyer to do the appeal...he should have prepared to deal with that issue at the beginning. You might try to make that case yourselves at the appeal hearing. Or just pay the extra fee and have him try it. But ask what additional info is going to be presented now that he didn't cover in the original paperwork that he now wants to charge for that makes him think he could get the original decision overturned.

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