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What causes a Medi-Cal denial? 2 possible reasons

On Behalf of | Dec 7, 2022 | Medi-Cal and Long Term Care Planning

If you have a limited amount of assets and income and you’re elderly or disabled, then it’s likely you’re eligible for the Medi-Cal program. Medi-Cal is a needs-based system that covers many medical benefits such as long-term care.

You shouldn’t delay applying for Medi-Cal If you believe you’re eligible. However, even if you meet all the requirements to obtain the benefits, your application may be denied. Here are two potential reasons:

1. You don’t meet the technical requirements.

There are several ways to be considered eligible for Medi-Cal, including being at least 65 years of age, disabled and meeting residency requirements. Alternatively, if you’re a resident at a long-term care nursing facility, then you may be eligible for Medi-Cal.

You also have to meet basic income and resource guidelines, which are redetermined on an annual basis. Many people are denied because they don’t realize they simply don’t qualify.

2. There’s an error in your application.

The easiest way for a Medi-Cal denial to occur is because there was an error during the application process. This can happen in one of two ways:

  • The applicant made an error during the application process. This often happens because the paperwork can be confusing, especially for people who are applying for the first time. Often, this may be tied to forgetting to provide required income verifications.
  • The caseworker made an error during the application process. While it’s their job to review an application, human error is always possible. A hurried review could lead to an easy mistake.

A Medi-Cal denial can easily deter you from getting the benefits you deserve, especially when you believe you did everything under your power to ensure your paperwork is accurate. If you believe your application was correct, then you may need to know your legal options