What if the notice is incorrect–either for myself and/or members of my household?
You can request a hearing. This video explains who in the family should stay eligible for Medicaid.
How can I make sure Medicaid benefits do not stop? If you submit your hearing request before the date the notice says Medicaid benefits will end, the benefits will continue at least until the hearing decision. For example, you received a notice dated May 20, 2023 that says that Medicaid is ending on May 31, 2023 for your children because “you are over income.” After watching the video you know that your children are eligible for Medicaid. If you file your appeal before May 31, their Medicaid coverage will continue without interruption.
What happens if I continue receiving Medicaid pending my appeal, and I lose? Although the notice says you will be responsible to repay the continued benefits if the hearing decision is not in your favor, under DCF policy you would only be required to repay benefits for family-related Medicaid if a court finds you committed fraud.
What if I don’t appeal before the date that Medicaid coverage ends? You can still submit a hearing request after the benefits end, up to 90 days after the date at the top of the notice (not the date the benefits ended). Your benefits will end on the date stated in the notice, but will be reinstated if you win the appeal. It is important to file an appeal if the termination was incorrect and you then incur medical bills. The only way to get reimbursed is if you successfully appealed.
What is the best way to request an appeal? Appeals can be requested multiple ways, including calling DCF, mailing a request or going to a DCF office, but it is best to either complete an Online Request here or by sending an email to email@example.com. If you want advice on your appeal, you can contact a legal aid program in your area (this link has program contact information). Or you can submit this online form and send a copy of your denial notice to the Florida Health Justice Project at this email: firstname.lastname@example.org.
What will happen after I file an appeal? A DCF supervisor may contact you after you file the appeal to discuss your case. You should only agree to withdraw your appeal if you are fully satisfied with the explanation and/or change offered by the DCF representative.
What should I do if the DCF notice says Medicaid is ending due to “failure to renew”? If the reason for termination is that you didn’t submit information needed to determine eligibility and you believe you are still eligible, you should submit the requested information even if you have filed an appeal. You have 90 days from the date your Medicaid ends to do this, without having to complete a new application.
What if I need help with my renewal? You should contact a local navigator. Contact information is here and you can request an appointment here.
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