ArticlesBlog

Marketplace Matters: Appeals

Marketplace Matters: Appeals


Hi, I’m Denice Sieron, and this is Marketplace Matters. Did you know that you can file an appeal if you disagree with the decision about your Health Insurance Marketplace application? It’s true. When you apply for health coverage through the Marketplace you’ll get a notice explaining the coverage and help with costs each person on the application qualifies for. If you think any of this information is wrong, you have 90 days from the date of the notice to start the appeals process. Here are a few examples: Alicia’s notice said that she was only eligible to get $40 a month in premium tax credits. She thinks she qualifies for more, so she submitted an appeal. Dave thought he qualified for Medicaid and his children qualified for the Children’s Health Insurance Program, called “CHIP”… but they were found ineligible. He’ll contact the Marketplace to see if he should file an appeal through the Marketplace or through his state. Ben wanted to buy a Marketplace plan after open enrollment ended. He applied for the Special Enrollment Period in April, but he was turned down. Ben is appealing that decision. There are various reasons you can file an appeal, but you must start the process in writing either with an appeal’s request form, or by writing a letter to the Marketplace. If you have an urgent health situation, you can ask for an expedited appeal. No matter what kind of appeal you make, remember to keep copies of all your paperwork, notes from phone calls, and any letters you get. You can appeal most decisions, but know that some issues can’t be resolved through an appeal. To learn more about appealing a marketplace decision, visit HealthCare.gov/marketplace-appeals Don’t miss out on the latest news and updates from the Marketplace. Here’s how to stay connected…

Comment here