How long do I have to appeal a health insurance denial?

Federal rules give you at least 180 days from the date of the denial to file an internal appeal. Some plans and states set different windows, and urgent cases can be expedited (often decided within 72 hours).

What if I missed the appeal deadline?

You may still have options. Ask the insurer about a good-cause exception, check your state's external-review window, and act immediately — some paths remain open after the internal deadline.

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How long do you have to appeal a denial?

The clock usually starts on the denial date. Missing the window is the most common way a winnable appeal is lost — so this is the first thing to pin down.

The federal baseline

Internal appeal: at least 180 days from the denial to file (federal minimum for most plans).
External review: typically 4 months (about 120 days) after the final internal denial to request it.
Expedited / urgent: if delay would seriously jeopardize your health, you can request a fast track — often decided within 72 hours.

Your plan or state may set different (sometimes shorter) windows, and self-funded ERISA plans follow the federal rules. Always check the deadline printed on your denial letter.

Missed the deadline?

You may still have a path. Ask the insurer about a good-cause exception, check whether your state's external-review window is still open, and act immediately. Don't assume a missed internal deadline ends it.

Deadlines by state

Internal-appeal and external-review windows for state-regulated plans. Click your state for the full rules, expedited timeline, and consumer-assistance options.

State	Internal appeal	External review	Process
Alabama	180 days	127 days	Federal
Alaska	180 days	127 days	State
Arizona	180 days	127 days	State
Arkansas	180 days	127 days	State
California	180 days	127 days	State
Colorado	180 days	127 days	State
Connecticut	180 days	127 days	State
Delaware	180 days	127 days	State
District of Columbia	180 days	127 days	State
Florida	180 days	127 days	Federal
Georgia	180 days	127 days	Federal
Hawaii	180 days	127 days	State
Idaho	180 days	127 days	State
Illinois	180 days	127 days	State
Indiana	180 days	127 days	State
Iowa	180 days	127 days	State
Kansas	180 days	127 days	State
Kentucky	180 days	127 days	State
Louisiana	180 days	127 days	State
Maine	180 days	127 days	State
Maryland	180 days	127 days	State
Massachusetts	180 days	127 days	State
Michigan	180 days	127 days	State
Minnesota	180 days	127 days	State
Mississippi	180 days	127 days	State
Missouri	180 days	127 days	State
Montana	180 days	127 days	State
Nebraska	180 days	127 days	State
Nevada	180 days	127 days	State
New Hampshire	180 days	127 days	State
New Jersey	180 days	127 days	State
New Mexico	180 days	127 days	State
New York	180 days	127 days	State
North Carolina	180 days	127 days	State
North Dakota	180 days	127 days	State
Ohio	180 days	127 days	State
Oklahoma	180 days	127 days	State
Oregon	180 days	127 days	State
Pennsylvania	180 days	127 days	State
Rhode Island	180 days	127 days	State
South Carolina	180 days	127 days	State
South Dakota	180 days	127 days	State
Tennessee	180 days	127 days	State
Texas	180 days	127 days	Federal
Utah	180 days	127 days	State
Vermont	180 days	127 days	State
Virginia	180 days	127 days	State
Washington	180 days	127 days	State
West Virginia	180 days	127 days	State
Wisconsin	180 days	127 days	Federal
Wyoming	180 days	127 days	State

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Sources: HealthCare.gov, appeals and external review; 45 CFR §147.136; state insurance-department rules (per-state pages). General information, not legal advice — see our methodology.