How to appeal a Marketplace decision

What can I appeal?

• Buy a Marketplace plan or 
  Catastrophic coverage

  Health plans that meet all of the requirements applicable to other Qualified Health Plans (QHPs) but don't cover any benefits other than 3 primary care visits per year before the plan's deductible is met.

  Refer to glossary for more details.

  .
• Get financial help with Marketplace costs (including the amount you think you qualify for).
• Enroll in or change your Marketplace plan with a
  Special Enrollment Period

  A time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you’ve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.

  Refer to glossary for more details.

  .
• Get an
  exemption

  If you’re 30 and older and want Catastrophic coverage, you must qualify for a "hardship" or "affordability" exemption.

  Refer to glossary for more details.

  .

• If the Marketplace didn’t let you know your eligibility results soon enough.
• The date your Marketplace coverage started.
• Other decisions if you live in certain states.
  • If you live in Alabama, Alaska, Louisiana, Montana, Virginia, West Virginia, or Wyoming, you can also appeal if you're told you're not eligible for Medicaid or the Children's Health Insurance Program (CHIP).
  • If your state has its own Marketplace website, you can appeal their decision. Check for your state.

Can I appeal more than 90 days from the date of my Eligibility Notice?