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.

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.
  1. We’ll review your appeal, including the information the Marketplace uses to confirm your eligibility.
  2. 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.
  3. 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.
  4. If you disagree with the decision, you can request a hearing. Hearings are over the phone.
Notice:
Save copies of all forms and letters related to your appeal. You can also request a copy of your appeal record (PDF, 1.22 MB)

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 coverageIf you can buy a Marketplace plan
Your ability to get premium tax credits or cost-sharing reductionsIf you qualify and how much you qualify for