If you already get Social Security or SSI benefits because of a disability, you can get Medicaid. If you don’t get Social Security or SSI, but you have a disability, you have to prove that you are disabled. Many people are denied because they aren’t able to prove that they’re disabled.
It is very important that you provide your caseworker with all available medical evidence to show you have a disability. If you do not have any current medical evidence and cannot afford to pay to see a doctor, HFS must pay for a medical examination. Often, it is necessary to file an appeal and get a lawyer to establish that you are "disabled" and eligible for Medicaid.
Even if you are eligible for Medicaid, they may deny coverage of a medical service or medical equipment. Common reasons for denial include:
- Failure to obtain pre-approval
- The treatment or equipment is not medically necessary
- There are more cost effective alternatives
- The medical service or item is not a Medicaid covered service