Questions & answers · Health insurance
Is the Medicare Part D Level 2 review automatic, or do I file it?
Health insuranceAppealChecked Nov 5, 2026
From K.Actuary, founded by Sangmin Kwon, ASA · sources checked 2026-11-05 · Source: 42 CFR 423.600 (eCFR (current as of 2026-11-02)) · § 423.600(a) View original ↗
In short
- Usually you must ask for Level 2 yourself, in writing.
- File within 60 days after you get the plan's Level 1 decision.
- If the plan misses its Level 1 deadline, it must send your case on.
What this means
Usually, you start it. You, or your prescriber acting for you, must file a written request with the Independent Review Entity (IRE) within 60 calendar days after you receive the plan's written redetermination (the Level 1 decision) [1]. There is one exception. If the plan misses its deadline to decide your Level 1 appeal, that counts as a denial. The plan must then send your request to the IRE within 24 hours after the deadline passes [2].
Where this comes from (2)
[1] 42 CFR 423.600 (eCFR (current as of 2026-11-02)) · § 423.600(a) · checked 2026-11-05
The enrollee, or the enrollee's prescribing physician or other prescriber (acting on behalf of the enrollee) must file a written request for reconsideration with the IRE within 60 calendar days after receipt of the written redetermination by the Part D plan sponsor.
[2] 42 CFR 423.590 (eCFR (current as of 2026-11-02)) · § 423.590(c) · checked 2026-11-05
(c) … If the Part D plan sponsor fails to provide the enrollee with a redetermination within the timeframes specified in paragraphs (a) or (b) of this section, the failure constitutes an adverse redetermination decision, and the Part D plan sponsor must forward the enrollee's request to the IRE within 24 hours of the expiration of the adjudication timeframe.
How we found this
We matched your question to 2 official sources, quoted the exact lines, and re-checked each quote against its source on 2026-11-05.
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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