Healthcare

What happens after I file an appeal?

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After we get your request, we'll send you a letter that lets you know we got it.

  • If your appeal request is accepted: We’ll review your appeal and any documents that you sent.
  • If the letter says your appeal request is invalid: You may need to submit more information or find other ways to get help. Learn what to do if your Marketplace appeal is invalid (PDF, 171 KB).

If you have a Marketplace account, you can check its status:

  1. Log into your Marketplace account.
  2. Select your current application.
  3. Select "Eligibility & appeals," and the link "File new appeal or check your appeal's status."

Generally, we process appeals in the order we get them. How long it takes for a decision usually depends on the issue you're appealing, if your appeal is expedited, and if we need documents.

Steps to resolve your appeal

  1. Appeal submitted: We got your appeal.
  2. In review: We'll review your appeal form and any documents that you submitted.
  3. Informal resolution: After our review, we'll follow up with you if we have questions or need more information. Then, we'll send you a letter called "Informal Resolution" with the results of your appeal.
  4. Hearing: If you disagree with your informal resolution results, you can request a formal hearing.
  5. Decision: When your appeal has a final decision, you'll get a letter with next steps.

Save copies of all forms and letters related to your appeal. If you want all the documents related to your case, contact the Marketplace Appeals Center at 1-855-231-1751 (TTY users can call 711), or fill out and submit this form (PDF, 1.22 MB).


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