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Applicant & Member Appeals


Individuals have the right to appeal an action that denies, reduces, or terminates Medicaid / FAMIS coverage.

As part of the appeal process, an impartial representative will conduct a review to determine whether your request for coverage should be approved based on applicable law and policy. The end result of the appeal is a written decision. Decisions by the DMAS Appeals Division may be appealed to court for review of the record. Learn more: 

Client Appeal Overview [pdf]

Descripción general de la apelación [pdf]

Client Appeal Frequently Asked Questions [pdf]

Apelaciones de clientes preguntas frecuentes [pdf]