Medicaid denied it

My niece was denied by Medicaid because she isn't old enough!  She spoke with the medical director who denied the claim and he suggested she appeal it because it would be reviewed by a different person who may waive that issue due to the other co-morbidities.  How do you appeal the age issue?  The doctor who denied it was very clear that she met all other criteria except the age.  His exact comment was "If you were 21 instead of 19 you would be approved today".  There's not a lot to appeal about your age.  Can anyone help us? Thank you!

Appeal it... there is always a process for appeals. They may yet say no, but it never hurts to try.

When it is appealed, tell your neice to be sure to get the surgeon's involvement in it. With appeals, there is usually a 'board' of professionals to review each situation. If the surgeon is stating that your neice needs the surgery, the board will probably forego the '21' rule. Sometimes, all it takes is for the surgeon to make a personal phone call to those who make the decision. Have your neice to ask him/her if they will speak to the appeal board on their behalf via phone. Also, have her call Medicaid to see if they'll give her the number for the appeal board so she can supply it to the surgeon. Best of luck to her! Sherri