Understand your denial
Know your deadlines
Turn the date on your notice into the dates you and the plan each have to meet.
Do this today
- Use the tool: Deadline calculator Turn the date on your notice into the dates you and the plan each have to meet, with the rule behind each one.
- Read: Appeal deadlines by coverage type 6 minute read. A table of the first appeal deadline and the next level. It covers job-based, Marketplace, Medicare, Medicaid, TRICARE, Veterans Affairs and other coverage. Each is counted from a stated date.
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Put this step on My Plan
So you can come back to it, and keep your dates and calls in one place.
In brief
- Deadlines depend on your kind of coverage, and most are counted from the date you receive or the date printed on the notice.
- For job-based plans and individual plans that are not grandfathered, 180 days is a floor, not a ceiling, and the external review window is a separate four months.
- Medicare, Medicaid, TRICARE and Veterans Affairs each have their own clocks, and some are measured in days, not months.
- Check the date on your notice, which controls.
More guides, tools and letters
More guides, tools, letters 8
Guides
- Appeal deadlines by coverage type
A table of the first appeal deadline and the next level. It covers job-based, Marketplace, Medicare, Medicaid, TRICARE, Veterans Affairs and other coverage. Each is counted from a stated date.
- How deadlines are counted, and what to do if you missed one
How to tell which date your deadline counts from. Learn what an "at least" minimum means, how weekends are handled where the rules say, and what to try if a deadline has passed.
- Is it worth appealing: what the numbers say
What published figures show about how often appeals change denials. The numbers from different programs cannot be compared. Here is how to decide for your own case.
- Your rights when a health plan says no
The main rights federal rules give you after a denial, in plain words, with the limits. See what a private plan must do and what Medicare, Medicaid and other programs add or change.
Tools
- Tool
Deadline calculator
Turn the date on your notice into the dates you and the plan each have to meet, with the rule behind each one.
Letters and scripts
- Letter or script
Tell the plan it missed its deadline
A letter that tells your plan it did not decide your claim or appeal in time, quotes what the federal rule says follows, and asks the plan to confirm in writing what it did and where you now stand.
Programs and services
- Program or service
AppealArmor
A free web tool that reads a photo or text of your denial letter, shows you what it read, and emails an appeal letter and a Next Steps sheet with where to send it and your deadline. It also has a deadline calculator.
From AppealArmor
- Program or service
Health Appeal
A free service with an in-page deadline check and an appeal letter builder that works inside an artificial intelligence (AI) assistant or on its site. You sign and send the letter yourself.
From Health Appeal
Questions to keep handy
- What exactly was denied, and under which part of the plan?
- What is my deadline, and what is it counted from?
- Where and how do I send my request, and how will I prove it arrived?
- Who decides, and can I ask for a faster decision?
Not what you need? Find a person who can help, or search the whole site.