Health plan external review
How long you have to appeal a health plan, Medicare, Medicaid, disability plan or Social Security decision, and how long the decision usually takes.
Checked on official source| Deadline to appeal | 4 months after the final internal denial |
|---|---|
| How long the decision takes | 45 days; 72 hours if urgent |
| Next step if you lose | The decision is binding on the plan if it rules for you |
| Federal rule | 45 CFR 147.136 |
Count days from the date on your notice, and keep a copy of everything you send. If you miss a deadline, ask whether you can show good cause for filing late; many programs allow it.
General information only, not legal, insurance or financial advice. Not affiliated with any government agency. Exceptions can apply. Confirm with the agency that sent your notice or a licensed professional.
How we checked this
Deadlines come from the federal regulations cited on each page; 2026 Medicare dollar thresholds come from CMS's notice of December 4, 2025. Your notice may give a different deadline; follow the notice. Last checked: November 12, 2026. Laws change; confirm with the state agency or a licensed professional before acting.
Cross-checked sources agree Checked on official source confirmed on a government, court or legislature site From a statute-cited table one detailed source Under review sources disagree; read the note and the law.