How long do I have to appeal a denial from a plan I bought on HealthCare.gov?

Health insuranceAppealChecked Nov 6, 2026

From K.Actuary, founded by Sangmin Kwon, ASA · sources checked 2026-11-06 · Source: HealthCare.gov · Internal appeals · How long does an internal appeal take? View original ↗

In short

Appeal within 180 days of the denial.
The plan decides in 30 days, or 60 for care you already got.
Then you can ask for an outside review within four months.

What this means

You must file your internal appeal within 180 days (6 months) after you get the denial notice [1]. If the appeal is for care you haven't had yet, the plan must finish it within 30 days. If it is for care you already had, the plan must finish within 60 days [1]. A plan you bought on your own (not through a job) has only one level of internal appeal [2]. After that, you can ask for an external review. You must ask within four months after you get the denial or the final internal decision. State processes must allow at least four months [3].

Your next step

Find the date you got the denial notice. File your internal appeal within 180 days of it [1]. If the plan still says no, ask for an external review within four months [3].

Check it yourself

Open HealthCare.gov's "Internal appeals" page and read "How long does an internal appeal take?". Your denial notice tells you how to file with your plan.

Where this comes from (3)

[1] HealthCare.gov · Internal appeals · How long does an internal appeal take? · checked 2026-11-06
Within 15 days if you’re seeking prior authorization for a treatment Within 30 days for medical services already received Within 72 hours for urgent care cases … You must file your internal appeal within 180 days (6 months) of receiving notice that your claim was denied. … Your internal appeal must be completed within 30 days if your appeal is for a service you haven’t received yet. Your internal appeals must be comp…
[2] eCFR · 45 CFR 147.136 · § 147.136(b)(3)(ii)(G) · checked 2026-11-06
a health insurance issuer offering individual health insurance coverage must provide for only one level of internal appeal before issuing a final determination.
[3] eCFR · 45 CFR 147.136 · § 147.136(d)(2)(i); (c)(2)(vi) · checked 2026-11-06
A group health plan or health insurance issuer must allow a claimant to file a request for an external review with the plan or issuer if the request is filed within four months after the date of receipt of a notice of an adverse benefit determination or final internal adverse benefit determination.

How we found this

We matched your question to 3 official sources, quoted the exact lines, and re-checked each quote against its source on 2026-11-06.

What we don’t know yet

Your own plan or notice may say something different. If your letter cites another rule, send it and we will look again.

Every answer is checked against the official rule it quotes.

Information only — not legal advice. Your plan, insurer or agency decides.

This answer quotes the official sources listed above, with the date we checked them. Your own policy, notice and state rules control. We are not your lawyer or your insurer. We don’t file, argue or negotiate claims for you — you send any letter or form yourself.

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