After you apply · Appeals

How to appeal a Marketplace decision

If the Marketplace says you can’t enroll, can’t get savings or got the wrong amount, you can ask for an appeal. Here’s what qualifies and the deadline.

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90 days from notice
Expedited if urgent
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Help me with a Marketplace decision

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Short answerIf you don’t agree with a Marketplace decision, you generally have 90 days from the date of your Eligibility Notice to ask for an appeal.^[1] If you were asked to submit documents, do that first; the updated decision may make an appeal unnecessary.^[1]

What you can appeal

Being found ineligible to buy a Marketplace plan or Catastrophic coverage.^[1]
Your financial help, including the amount you think you qualify for.^[1]
A denied Special Enrollment Period or exemption, a late eligibility decision, or your coverage start date.^[1]

What you can’t appeal here

The date the Marketplace ended your coverage, or your Form 1095-A.^[1]
Paying back excess tax credit after filing your taxes.^[1]
An insurer refusing a claim or ending coverage. That’s an appeal with the insurer: an internal appeal, then an external review by an independent third party.^[1,2]

Tips

Include copies, not originals, of supporting documents.^[3]
Ask for an expedited appeal if waiting could seriously put your health at risk.^[3]
A trusted person can act as your authorized representative.^[3]
If eligible, enroll and keep paying premiums during the appeal; dropping coverage may mean waiting to re-enroll even if you win. Tax credits used during an unsuccessful appeal must be paid back.^[3]
Past 90 days? Explain why when you file; you may get an extension.^[1]

Sources

HealthCare.gov, How to appeal a Marketplace decision: what can I appeal?. https://www.healthcare.gov/marketplace-appeals/
HealthCare.gov, How to appeal an insurance company decision. https://www.healthcare.gov/appeal-insurance-company-decision/
HealthCare.gov, How to appeal a Marketplace decision: how do I file an appeal?. https://www.healthcare.gov/marketplace-appeals/appeal-forms/

Checked October 16, 2026. 2027 Marketplace plans and final 2027 rates aren’t published yet; we’ll update this page when they are.

Frequently asked questions

How long do I have to appeal a Marketplace decision?

Generally 90 days from the date of your Eligibility Notice. If you miss it, explain why when you file; you may get an extension.

Can I appeal the amount of my premium tax credit?

Yes. You can appeal the financial help the Marketplace said you qualify for.

My insurer denied a claim. Is that a Marketplace appeal?

No. Appeal to the insurer through its internal appeal, then request an external review by an independent third party.

Will you sell my information?

No. Your information goes to Nexus Benefit Solutions only and is never sold.

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