Aid to continue is a request that keeps a benefit running exactly as it is while an appeal is decided, instead of letting it stop or shrink on the date the notice names. It makes no argument that the decision was wrong — that is the appeal’s job. It asks for the status quo until somebody has ruled.

It is a separate request from the appeal. That is the entire reason this entry exists. People call, ask for the hearing, hang up satisfied, and then go months without coverage or without home care hours while they turn out to have been right all along. Two different asks, one conversation, and only one of them is the one everybody remembers to make.

Its window is also shorter than the window for requesting the hearing. You can be comfortably on time for the hearing and far too late for the aid. The deadline for each is printed on the notice you received — read that notice, not a summary of it — and the practical rule follows from the gap between them: ask for both in the same call, on the day the notice arrives, and ask for aid to continue in those words. It is not automatic and it is not implied by asking for a hearing.

In New York: it belongs to the Medicaid fair hearing process, run by the state. That hearing is free, no lawyer is required, and interpreters are available both for the call that requests it and for the hearing itself. How fair hearings work.

The deadline itself is the part worth memorising, because it is not the hearing deadline. You have 60 days from the date of the notice to request a fair hearing. To keep the benefit running, the request has to come before the effective date printed on the notice, or within 10 days of the notice being mailed — whichever of the two is later. That is why both requests belong in the same call: the hearing window is long, the aid continuing window is short, and only one of them is obvious from the letter.

It matters most wherever a service is already running and the notice would interrupt it:

  • home care hours being reduced;
  • a managed long-term care plan ending or changing;
  • an ongoing authorization not renewed;
  • coverage closing at renewal.

The comparison that makes the point: a hearing may take weeks to schedule. For someone whose hours are being cut, aid to continue is the difference between care arriving on Monday and care stopping on Monday, whatever the hearing eventually decides.

A denial of something you have never had is a different situation. There is nothing running to continue, so aid to continue has nothing to hold in place, and the appeal is the whole of your case.

One honest caveat, because this gets described as free and it is not quite. If the appeal is lost, benefits paid out during the wait may in some circumstances be recoverable by the agency. That makes it a real decision rather than a costless default. It is usually still the right one where a service you depend on is about to stop — but it is a decision you should make with that possibility in view, not one you should be talked into or out of casually.

Also called: aid continuing, continuation of benefits pending appeal. Full guide: Medicaid fair hearings in New York.

More in Glossary of health coverage and billing terms

  • Tax household — The group whose income is counted together for coverage eligibility, decided by who files a tax return with whom rather than by who lives in the apartment.
  • Qualified health plan — A plan certified for sale on a health insurance marketplace, which guarantees a floor of benefits and protections and tells you nothing about the network.
  • Limited English proficiency — The administrative status that triggers free language help in health care, which describes an encounter rather than passing judgment on a person.

This page explains how the system works. It is not medical advice. More.