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Complaint or Fair Hearing

Should you submit a complaint or request a Medicaid Fair Hearing?

A Medicaid Fair Hearing request can be submitted if you have been turned down for a Medicaid service, or you were receiving a Medicaid service, but it was reduced or stopped. You should receive a letter explaining why Medicaid will not pay for or cover the service. When this happens, you may have the right to a Medicaid Fair Hearing. Only the Medicaid recipient or their legal/authorized representative can request a Fair Hearing.

If you are having other problems with Medicaid, you can submit a complaint. You do not have to be a Medicaid recipient to submit a complaint. Anyone can submit a Medicaid Complaint. Examples of issues that can be submitted as a complaint include:
  • Need help finding a doctor or dentist
  • Questions about an unpaid bill
  • Problems with transportation services
  • Trouble getting medical or dental care
  • Unhappy with quality of services