Questions & answers · Health insurance
My Medicare Advantage plan denied a service. How long do I have to appeal?
Health insuranceAppealChecked Nov 5, 2026
From K.Actuary, founded by Sangmin Kwon, ASA · sources checked 2026-11-05 · Source: 42 CFR 422.582 (eCFR (current as of 2026-11-02)) · § 422.582(a)-(b) View original ↗
In short
- File a Level 1 appeal within 65 days from the date on the notice.
- Your request should be in writing.
- If you are late, explain why. Good cause can help.
What this means
You have 60 calendar days to ask your plan for a Level 1 appeal (called a reconsideration). The 60 days start when you receive the written denial notice. The rule assumes you received it 5 calendar days after the date on the notice, unless there is proof otherwise [1]. Medicare.gov puts it simply: file within 65 days from the date on the initial denial notice sent by your plan [2]. If you miss the deadline, you can still ask. Your request must be in writing and say why you did not file on time [3]. The plan may give you more time if you show good cause [3].
Where this comes from (3)
[1] 42 CFR 422.582 (eCFR (current as of 2026-11-02)) · § 422.582(a)-(b) · checked 2026-11-05
a request for reconsideration must be filed within 60 calendar days after receipt of the written organization determination notice. (1) The date of receipt of the organization determination is presumed to be 5 calendar days after the date of the written organization determination, unless there is evidence to the contrary.
[2] Appeals in Medicare health plans · Appeals in a Medicare Advantage plan › Level 1 › How do I start an appeal? · checked 2026-11-05
You, your representative, or your doctor or healthcare provider must file an appeal within 65 days from the date on the initial denial notice sent by your plan . If you miss the deadline, you must give a reason for filing late.
[3] 42 CFR 422.582 (eCFR (current as of 2026-11-02)) · § 422.582(c) · checked 2026-11-05
If the 60-day period in which to file a request for reconsideration has expired, a party to the organization determination or a physician acting on behalf of an enrollee may file a request for reconsideration with the MA organization. The request for reconsideration and to extend the timeframe must— (i) Be in writing; and (ii) State why the request for reconsideration was not filed on time.
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 2026-11-05.
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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