Helping a Kidney Transplant Patient access Medicare Benefits

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Allen was born with kidney failure. At six months old, he was one of the youngest people in the Missouri to receive a kidney transplant and he has been on medications his entire life.

Allen is now 34 and his kidney is failing again. He must have a new kidney or he will die. His sister is a match and he has a transplant surgery scheduled. Unfortunately, the surgery will cost over $250,000. (Declining health forced Allen to give up his successful career as a mortician.) Allen applied for Medicaid and was denied.

Allen came to Legal Aid for help with his Medicaid denial. A Legal Aid paralegal requested all his medical records and asked for an administrative hearing. Allen’s health care providers were slow to respond and the most important medical records arrived and were faxed to the hearing officer on the morning of the hearing.

Allen and his paralegal arrived at the hearing and waited for the administrative hearings office to call. Ten minutes after the scheduled hearing time, the paralegal received a call and was told that the hearing officer had a chance to review the records sent that morning and had made an on the record decision in Allen’s favor.

Thanks to Legal Aid, Allen can have the transplant surgery. His doctors are optimistic and barring any compatibility issues, he should be able to return to work after a few months of recovery.