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Your Medicaid or Medicare Was Stopped

Your benefits were cut off or denied. This shouldn't happen without proper notice and a chance to appeal. Here's what you need to do right now.

Act Now: What to Do Immediately

1

Get the Notice in Writing

Call your state Medicaid office immediately and ask for a written explanation of why your benefits were stopped. You have the right to this information.

2

Request an Appeal (Fair Hearing)

You have 30 days from the date of the notice to request a fair hearing. Do this in writing or by phone. This stops the termination while you appeal.

3

Contact Your State Medicaid Office

Find your state's Medicaid office at medicaid.gov. Ask for the Appeals/Fair Hearing department. Be clear: "I want to appeal this decision."

4

Gather Your Documents

Collect proof of income, medical records, letters from doctors, and any correspondence about your case. Keep everything organized.

Federal Resources & Phone Numbers

Centers for Medicare & Medicaid Services (CMS)

1-877-267-2323

Federal agency that oversees Medicaid and Medicare. They can help if your state is not following federal rules.

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Medicaid.gov - Find Your State Office

N/A - Use Website

Official government site to find your state's Medicaid office and contact information.

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Medicare Appeals Line

1-800-MEDICARE (1-800-633-4227)

If your Medicare was stopped, call this number. They can explain your appeal rights.

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Patient Advocate Foundation

1-800-532-5274

Free help navigating insurance denials and appeals. They have counselors who can guide you.

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Understanding the Appeal Process

Your Rights

  • You have the right to a fair hearing before an independent judge
  • You can bring a representative (lawyer, advocate, or family member)
  • You can present evidence and witnesses
  • Benefits usually continue while you appeal (unless fraud is involved)
  • You can appeal the judge's decision to a higher court if needed

Timeline for Appeal

Day 1-30: Request your fair hearing in writing or by phone

Day 30-60: State schedules your hearing and sends you the date

Day 60-90: Your hearing takes place (can be by phone or in person)

Day 90-120: Judge issues a decision

Caregiver Notes

If you're helping someone navigate this process, here are key things to remember:

  • •Act quickly. The 30-day deadline is strict. Missing it means losing your right to appeal.
  • •Get everything in writing. Don't rely on phone calls alone. Send written requests and keep copies.
  • •Organize medical records. Doctors' letters supporting the need for benefits are crucial evidence.
  • •Consider legal help. Many legal aid organizations offer free representation for Medicaid appeals.
  • •Keep a timeline. Write down dates, names, and what was said in every conversation.

Learn More About the Law (Optional)

If you want to understand the federal laws that protect your Medicaid and Medicare benefits, here are the key statutes and regulations:

  • •Social Security Act Section 1902(a)(3): Requires states to provide notice and opportunity for a fair hearing before terminating Medicaid benefits.
  • •42 CFR 431.200-431.250: Federal regulations governing fair hearing procedures for Medicaid.
  • •Medicare Appeals Process (42 CFR 405): Federal rules for appealing Medicare denials and terminations.
  • •Medicaid Continuity of Care: Federal law requires benefits to continue during the appeal process in most cases.

View our Know Your Rights Map for a complete guide to disability civil rights laws and protections.

Need More Help?

If you're struggling with this process or need guidance specific to your situation, reach out to us. We're here to help.

Contact Us for Support

Quick FAQ (Plain Language)

Write down the date it stopped, request the reason in writing, and start a simple log of calls, letters, and notices.
Notices, letters, denial reasons, dates of calls, names/titles, and any service disruption impacts. Keep screenshots if needed.
Avoid sending protected health information through public forms. Keep communications factual and preserve originals.

Additional FAQ

No. This site is informational and provides links to public records and plain-language guidance.
Verified refers to items directly supported by linked records. Unverified refers to assertions that are labeled and presented for review.
Do not submit protected health information, full IDs, or sensitive personal data. Use redaction before sharing anything.
Use the page URL, the 'Last updated' date (if shown), and the Exhibit ID when available.
Document dates, who said what, what services were affected, and preserve written notices. Then follow the page's step-by-step checklist.

Related Public Record References

FOIA Archive

Access public records and freedom of information requests related to Medicaid and Medicare decisions.

Learn More

Evidence Standards

Learn how evidence is verified and what documentation standards apply to public records.

Learn More

Quick FAQs (Plain Language)

Write down the date your benefits stopped, the reason given (if any), and the names of anyone you spoke with. Keep all notices and letters you receive in a safe place.
The official notice of termination, proof of income, medical records from your doctor, and any correspondence about your case. These are your strongest evidence in an appeal.
Do not share full Social Security numbers, complete medical records, or financial account details on public forms. Redact sensitive information before sharing anything online.