Federal appeal deadlines: health, Medicare, Medicaid and Social Security
How long you have to appeal a health plan, Medicare, Medicaid, disability plan or Social Security decision, and how long the decision usually takes.
General information only, not legal, insurance or financial advice. Not affiliated with any government agency. Rules have exceptions; open your state for details and the law it comes from.
| Appeal | Deadline to appeal | Decision time |
|---|---|---|
| Disability plan (ERISA) appeal Checked on official source | 180 days from the denial notice | 45 days, with one 45-day extension allowed |
| Health plan external review Checked on official source | 4 months after the final internal denial | 45 days; 72 hours if urgent |
| Health plan internal appeal Checked on official source | 180 days from the denial notice | 30 days for care you have not had yet; 60 days for care already received; 72 hours if urgent |
| Medicaid managed care plan appeal Checked on official source | 60 days from the plan's notice | 30 days; 72 hours if urgent |
| Medicaid state fair hearing Checked on official source | Set by your state, up to 90 days from the notice | Generally within 90 days |
| Medicare Advantage plan appeal Checked on official source | 65 days from the plan's denial | 30 days for services; 60 days for payment; 72 hours if urgent |
| Medicare ALJ hearing (Level 3) Checked on official source | 60 days from the Level 2 decision; at least $200 must be in dispute in 2026 | Usually 90 days (often longer in practice) |
| Medicare Appeals Council (Level 4) Checked on official source | 60 days from the ALJ decision | Usually 90 days |
| Medicare fast appeal when care is ending Checked on official source | Call the Quality Improvement Organization by noon of the day before skilled nursing, home health or hospice care ends | By the end of the day before services end |
| Medicare federal court review (Level 5) Checked on official source | 60 days from the Appeals Council decision; at least $1,960 must be in dispute in 2026 | Set by the court |
| Medicare hospital discharge appeal Checked on official source | Call the Quality Improvement Organization by midnight of your planned discharge day | Usually within 1 day after the QIO has your records; you can stay in the hospital meanwhile without extra charge |
| Medicare Part D drug appeal Checked on official source | 65 days from the plan's coverage decision | 7 days; 14 days for payment requests; 72 hours if urgent |
| Medicare reconsideration (Level 2) Checked on official source | 180 days from the Level 1 decision | Usually 60 days |
| Medicare redetermination (Level 1) Checked on official source | 120 days from the Medicare Summary Notice or denial | Usually 60 days |
| Social Security ALJ hearing Checked on official source | 60 days from receiving the reconsideration notice | Varies; often a year or more including the wait for a hearing date |
| Social Security Appeals Council Checked on official source | 60 days from receiving the ALJ decision | Varies; often a year or more |
| Social Security federal court Checked on official source | 60 days from receiving the Appeals Council's notice | Set by the court |
| Social Security reconsideration Checked on official source | 60 days from receiving the notice (SSA assumes you got it 5 days after the date on it) | Varies; often several months |
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.