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What do I do if my MassHealth application is denied?

Healthcare is expensive, and securing health insurance to pay for medical visits, prescriptions, and emergencies is not possible for all Massachusetts residents.

While some individuals are able to get health insurance for themselves and their family members through their jobs, this option is not available to every person who lives in the state. For those with low incomes and those who are in need, MassHealth can help.

MassHealth is the conglomeration of Medicaid and the Children's Health Insurance Program, also known as CHIPS. It is a Massachusetts-specific service that provides qualifying individuals with assistance to get and pay for the medical care they need. A person must apply for MassHealth support to get it, and unfortunately some qualifying individuals find out their applications have been initially denied.

It is important for applicants to remember that there is an appeals process in place when MassHealth claims are rejected. Appeals may be initiated by fax or through written communications, and once an appeal has been started a person will receive notification of when they will have a hearing on their appeal. Individuals must be given at least 10 days' notice of when their appeals' hearings are to happen so that they can prepare.

There are many reasons that MassHealth applications and claims may be denied, and knowing how to approach an appeal can be hard on a person who just wants to secure healthcare for themselves and those they love. Attorneys throughout Massachusetts practice healthcare law and work with MassHealth clients to ensure that they are treated fairly and that their applications are properly reviewed and approved.

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