How to appeal a Marketplace decision
After you file an appeal
The Marketplace Appeals Center will mail you a letter within 10-15 business days.
- If your appeal request is accepted: We’ll review your appeal.
- If the letter says your appeal request is invalid: You may need to submit more information or find other ways to get help. Learn what to do if your Marketplace appeal is invalid (PDF, 136 KB).
How we process your appeal
Generally, we process appeals in the order we get them. How long it takes for a decision usually depends on the issue you’re appealing, if your appeal is expedited, and whether you need to submit documents.
- We’ll review your appeal, including the information the Marketplace uses to confirm your eligibility.
- You may get a letter asking for more information, like a copy of a passport. Send these documents as soon as possible to help us decide your case quickly.
- If we can decide your appeal informally we’ll mail you a "Notice of Informal Resolution." Generally, you’ll get this letter about 20 days after you submit any needed information.
- If you disagree with the decision, you can request a hearing. Hearings are over the phone.
Getting your appeal decision
You'll get a letter with the Marketplace Appeals Center's final decision that will explain any changes, how we made the decision, and your next steps.
| If you appealed: | The letter tells you: |
|---|---|
| Your eligibility for coverage | If you can buy a Marketplace plan |
| Your ability to get premium tax credits or cost-sharing reductions | If you qualify and how much you qualify for |