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How to appeal

If you don’t agree with a decision made by the Health Insurance Marketplace, you may be able to file an appeal.

You can appeal the following kinds of Marketplace decisions:

  • Whether you’re eligible to buy a Marketplace plan, including a Catastrophic health insurance plan
  • Whether you can enroll in a Marketplace plan outside the regular Open Enrollment Period
  • Whether you’re eligible for lower costs based on your income
  • The amount of savings you’re eligible for
  • A reduction in the amount of savings you are eligible for
  • Whether you’re eligible for Medicaid or the Children’s Health Insurance Program (CHIP). Note: This applies only in certain states where the federally facilitated Marketplace makes the Medicaid eligibility determination (Alabama, Alaska, Arkansas, Louisiana, Montana, New Jersey, Tennessee, West Virginia, and Wyoming)
  • Whether you're eligible for an exemption from the requirement to have health insurance
  • Whether the Marketplace made a timely determination about your eligibility after you applied

Note: If you've already filed an appeal, find out what happens next.