Can a Medicaid Applicant Be Billed for Services While the Application Is Pending?

Can a Pennsylvania resident applying for Medicaid be billed for medical and prescription services while the application is pending? Is there a difference if the original Medicaid application was denied and the patient is waiting for a determination on her appeal?

While I can’t comment on Pennsylvania law in particular, in general a patient cannot be billed or be required to pay medical invoices while a Medicaid application or an administrative appeal is pending. If the patient loses the administrative appeal and then goes on to appeal to court, she will be liable for paying the bill. Of course, most Medicaid applicants do not have the necessary funds in any case. To get a definite answer, however, you will need to consult with Pennsylvania counsel.

For more on Medicaid's rules, click here.