I missed the deadline to appeal my health insurance denial. Is there anything I can still do?

Start with the date your clock began. HealthCare.gov says you must file your appeal within 180 days of receiving notice that your claim was denied [1]. What counts is the date you received the notice. Was the letter late, sent to the wrong address, or never delivered? These sources do not say the plan must accept a late appeal in that case.

There is one door that does not turn on your own date. If a plan or issuer fails to strictly adhere to all the requirements of the internal claims and appeals rule for your claim, you are deemed to have exhausted that process [2]. You may then start an external review [2]. That door is about what the plan did wrong, not about a date you missed. But the rule names an exception, and you need to read it before you count on the door.

The process will not be deemed exhausted based on de minimis violations that do not cause, and are not likely to cause, prejudice or harm to you [3]. The plan has to show the violation was for good cause or beyond its control, and that it happened in an ongoing, good faith exchange of information [3]. That shield is not available if the violation is part of a pattern or practice [3]. You can request a written explanation of the violation, and the plan must provide it within 10 days [3]. If a reviewer or a court says the plan met that exception, you have the right to resubmit and pursue the internal appeal, and the time periods for re-filing begin to run when you receive the plan's notice of that chance [3].

Two more things are worth using. An external review has its own deadline: you must ask for it within 4 months of the final notice [4]. And HealthCare.gov says the Consumer Assistance Program in your state can file an appeal for you [1]. None of these sources promises that a late appeal will be taken.

Open the HealthCare.gov internal appeals page and read the 180-day line [1]. Then open 45 CFR 147.136(b)(2)(ii)(F) and read part (1) for the deemed exhaustion door [2] and part (2) for the de minimis shield [3]. Then check whether your denial letter gives the reason and the appeal address. Whether your own late appeal will be taken: "Don't know yet" here.