This process is for applicants/members who are applying for (or renewing) Medicaid eligibility and who are dissatisfied with some part of the eligibility process.
An eligibility grievance is an expression of dissatisfaction about any matter other than an eligibility decision.
Examples of an eligibility grievance might be:
The applicant or member or their authorized representative may submit an eligibility grievance by telephone or in writing.
No specific grievance form is required when submitting an eligibility grievance.
No, an applicant, member or their authorized representative may submit an eligibility grievance at any time.
The Medicaid agency will call or send a letter of grievance resolution to the applicant, member or their authorized representative within 30 calendar days following the date of resolution of the grievance.