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  7. Choices for Care

If You Are Denied for Choices for Care

You may be told that you are not eligible for Choices for Care Long-Term Medicaid. If this happens, you must be told why you were denied.

If you disagree, ask them to change their decision by asking for a “review” or making an “appeal.”

If you do not meet clinical requirements

The Vermont Department of Disabilities, Aging and Independent Living (DAIL) decides if you have physical issues that make it hard for you to do daily activities. If they tell you that you don’t meet the clinical (physical) requirements of Choices for Care, you have two options:

  1. You can request a DAIL Commissioner’s Review within 30 days of getting a Choices for Care decision. Information about how to ask for a Commissioner’s Review must be included in the letter you get from DAIL. The letter will also tell you how to get help if you disagree with the decision. The phone number for DAIL’s central office is 802-241-2401.
  2. You can also make an appeal to the Human Services Board within 90 days of getting a Choices for Care decision. Information about how to ask for an appeal must be included in the letter you get from DAIL. The letter will also tell you how to get help if you disagree with the decision. The Human Services Board’s mailing address is 14-16 Baldwin Street, 2nd Floor, Montpelier, VT 05633-4302. You can call them at 802-828-2536; fax them at 802-828-3068; and email them at [email protected].

If you do not meet financial requirements

The Economic Services Division (ESD) within the Department of Vermont Health Access decides on your financial need for Choices for Care. If they tell you that you don’t meet the financial requirements, you can make an appeal.

You can appeal to the Human Services Board within 90 days of getting the decision by either calling the ESD Benefits Center at 1-800-479-6151 or the Human Service Board at 802-828-2536. Information about how to ask for an appeal must be included in the letter you get from the Economic Services Division. The letter will also tell you how you can get help with appealing the decision.   

We can help you

We can discuss your options with you before you start a review or appeal. Fill out our form and someone from Legal Services Vermont or Vermont Legal Aid will call you.