Health insurance appeal deadlines you need to know
Federal rules give you 180 days to file an internal appeal and 120 days to request external review. Here are the deadlines by plan type.
Federal deadlines
ERISA group health plans and ACA marketplace plans: 180 days from the date of denial to file an internal appeal.
External review: 120 days from the final internal denial.
Expedited appeals: insurer must decide within 72 hours.
Medicare and Medicaid
Medicare Advantage: 60 days for the first reconsideration.
Medicaid managed care: typically 60 days, with the right to a state fair hearing in parallel.
Original Medicare: 120 days for the first redetermination.
Upload the denial letter. Free analysis first, finished letter second.
FAQ
What happens if I miss the 180-day window?+
Some plans allow a late appeal for good cause; many do not. File as soon as possible and ask about a good-cause exception in writing.
More guides
- How to write a health insurance appeal letter
- Internal appeal vs external review: what is the difference
- Expedited appeals: when to ask for an urgent review
- The No Surprises Act and out-of-network bills