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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)

Read the appeal instructions and deadline on your notice now. Medicaid and Medicare use different processes. Ask the issuing agency or plan how to request an appeal, an urgent review when applicable, and any continuation of benefits. An appeal does not automatically keep every benefit in place.

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.

Visit Website

Medicaid.gov - Find Your State Office

N/A - Use Website

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

Visit Website

Medicare Appeals Line

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

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

Visit Website

Patient Advocate Foundation

1-800-532-5274

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

Visit Website

Understanding the Appeal Process

Your Rights

  • The available review process depends on your program and decision. Read the notice to identify the reviewing agency or plan.
  • You can bring a representative (lawyer, advocate, or family member)
  • You can present evidence and witnesses
  • Continuation of benefits has separate conditions and deadlines. Ask promptly whether you must request it and whether repayment could apply.
  • Read each decision for any further review rights, filing destination and deadline; not every stage is a court proceeding.

Build your notice-specific timeline

Notice: Save the notice, mailing date, date received and proposed change date.

Deadline: Record the exact appeal deadline and where the notice says to file. Ask about urgent review if needed.

Continued benefits: Ask separately about continuation requirements, its deadline and possible repayment.

Confirmation: Keep proof of submission, the reference number and the next written response. Do not assume a hearing or decision date.

Caregiver Notes

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

  • •Act quickly. Use the deadline on your notice, not a generic day count. If it has passed, ask promptly whether a late request can be considered; do not assume all review rights are lost.
  • •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:

  • •Medicaid fair hearings: 42 CFR Part 431, Subpart E describes notice, hearing procedures and applicable conditions. It is not one deadline for all programs.
  • •42 CFR 431.200-431.250: Federal regulations governing fair hearing procedures for Medicaid.
  • •Medicare appeals: Medicare.gov explains the different appeal routes for Original Medicare, health plans and drug plans, including fast appeals for certain services ending.
  • •Medicaid managed-care continuation: 42 CFR 438.420 sets conditions for continued benefits and possible recovery of costs. Continuation is not a blanket guarantee.

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

Need More Help?

This archive cannot file an appeal, represent you or stop a deadline. For case-specific help, contact the agency or plan named on your notice, a qualified adviser or legal aid. Do not send private medical records through public archive forms.

Read archive contact and privacy limits

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.

Read the notice before choosing your next step

Use these five checks while reading the guide. Checking a box records your own progress, not a finding that the evidence is sufficient or a right was violated.

Mark a step after you have checked it or recorded what is missing.

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This is not an intake form, submission or legal assessment. No names or private records are requested. Checkmarks are not sent or saved by this tool; reload to start over. Human review of comprehension remains separate.