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Elder Law Office of David Wingate, LLC

Posts Tagged ‘denial’

Medicaid – same-sex spouse or domestic partner beneficiary – Transfer of Assets

Transfers of Assets: States are required to have provisions regarding transfers of assets for less than fair market value under sections 1902(a)(18) and 1917(c) of the Act. A State Medicaid plan must provide that, if an institutionalized individual or the spouse of an individual transfers assets for less than fair market value after the “look-back” date defined in the statute, the State will calculate and impose a period of ineligibility. Medicaid payment is not available for the long-term care services the individual receives during the period of ineligibility, although the individual remains eligible for Medicaid coverage of non-long term care…

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What Do You Do When Medicare Says ‘No’

Your doctor suggests you have a minor operation procedure. You took your doctor’s advice and you went ahead with the procedure. However, Medicare won't pay for it. What is your recourse? Appeal. Medicare covers procedures that are deemed medically necessary. "Appealing is easy and most people win so it is worth your while to challenge a Medicare denial," says the Medicare Rights Center, a national nonprofit organization. The denial of coverage may be due, for example, to a simple coding error in your doctor's office. People have a strong chance of winning their Medicare appeal. According to Center, 80 percent…

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