Notice and Appeals: Medicaid and the Marketplace. Notice and Appeals. Question: What will eligibility notice and appeals processes be for MAGI-Medicaid and Marketplace applicants? Answer:
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What will eligibility notice and appeals processes be for MAGI-Medicaid and Marketplace applicants?
Recent federal regulations have provided some information about guidelines for appeals and notices but we are still at the beginning of understanding exactly how these processes will be implemented in Illinois.
All applications will trigger a written eligibility decision.
This notice will include appeal rights and process.
Medicaid appeals must be filed within 60 days of the decision.
If an applicant is found not eligible for Medicaid on appeal, the state will inform the Marketplace so that the applicant will get connected to health insurance options there. (The exact details of this process are being worked out now.)
Timing—when applicant submits and application AND on notice of eligibility determination.
Including: explanation of appeal rights; description of how to request an appeal; right to represent self or bring a representative; right to continuing benefits; fact that change may affect whole household.