Will Medicaid keep paying for my care while my appeal is pending?

This is about Medicaid managed care plans. A federal rule, 42 CFR 438.420, covers them. The plan has to keep your benefits going if all of these are true. You filed the appeal on time. The appeal is about ending or cutting a service the plan had approved. A provider ordered the service. The time of the first approval has not run out. And you asked for the care to continue in time [1].

You ask in time if you ask by the later of two dates. One is 10 days after the plan sent the notice. The other is the day the cut is to start [1]. The care goes on until something ends it, like you dropping the appeal [1]. One risk: if you lose, the plan may recover the cost of that care. This follows the state's usual policy on recoveries [1].

Your plan's notice and your state Medicaid office tell you the exact steps. This does not cover Medicaid that is not run through a managed care plan — "Don't know yet".