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.
- If you live in Alabama, Alaska, Louisiana, Montana, New Jersey, Virginia, West Virginia, or Wyoming, you can also appeal a denial of Medicaid eligibility through your state, instead of the Marketplace.
- If you live in Alabama, Alaska, Louisiana, Montana, New Jersey, Virginia, or West Virginia, you can also appeal a denial of CHIP eligibility through your state, instead of the Marketplace.
- 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.