It is my understanding that some tiers letter still have not been received.  Much of this information is from Aaron Nangle of If you believe that the tier you have been placed in will not meet your needs, you can appeal.  But there is a process.

        It is very important to send a letter of appeal within 10 days of the time you receive your tier assignment.  In this way, you will be able to keep the services you currently have.

        If you appeal within 10 days and you desire to keep your services, you are advised to keep the original envelop that your tier assignment came in.  In this way, you can prove the date that you received your letter.  If you don’t apply within 10 days, you can still appeal your tier assignment withn 30 days but you will not be able to continue with your current services.

        If you are appealing your tier assignment, do not sign a new cost plan.  This will be a contract.  If you sign it, you are saying that you agree with the cost plan you are presented with.  This could and probably will void your appeal.

        Understand that it will be easy for you to move down a tier but hard to move up. 

        Personal Care Attendants (PCA) may not be included in your Waiver funding.  However, if you are under the age of 21, this service is available to you through Medicaid funding.  If you have been excluded from this service because of the tier you are in and you are under 21, try to receive this service through a different funding stream.

         Because the tiers are mandated by the legislature, not APD, the appeal process is somewhat different from other appeals.  They are also more difficult to win.  Your appeal must be written from the point of view that the services you will receive in your new plan will not meet your health and safety needs.