Appeal

What is an Appeal?

A request to your health insurer or the Health Insurance Marketplace® to reconsider a decision that denies a benefit or payment.

If you do not agree with a decision made by the Marketplace, you can lodge an objection. Small businesses can also appeal decisions made by the Small Business Health Options Program (SHOP).
If your health insurer refuses to pay a claim or terminates your coverage, you have the right to appeal the decision and have it reviewed by a third party.

References

“Glossary.” HealthCare.gov, www.healthcare.gov/glossary/.

CMS.gov. Glossary of Health Coverage and Medical Terms. CMS.gov, 2020. https://www.cms.gov/CCIIO/Resources/Forms-Reports-and-Other-Resources/Downloads/Uniform-Glossary-01-2020.pdf. PDF file.

Find the best health insurance coverage in your state.

Get up-to-date plans and prices for individual & family health insurance.

Find the best health insurance coverage in your state.

Get up-to-date plans and prices for individual & family health insurance.

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This website is operated by Palmetto Health Pro, dba Marketplace America, under agent Tina Knight NPN: 17109406 and is not the Health Insurance Marketplace website. Click here for a listing of licensed states and state license numbers. In offering this website, Marketplace America is required to comply with all applicable federal laws, including the standards established under 45 CFR 155.220(c) and (d) standards established under 45 C.F.R. 155.260 to protect the privacy and security of personally identifiable information and state insurance laws applicable to ACA plans. This website may not display all data on Qualified Health Plans being offered in your state through your state or the federal Health Insurance Marketplace website. To see all available data on Qualified Health Plan options in your state, go to your state Health Insurance website or the federal the Health Insurance Marketplace website at HealthCare.gov. The rates displayed on this website are cost estimates and though we attempt to be as close to your final cost share as possible, it cannot be determined until you verify your eligibility by completing the application process via the federal or state marketplace. For quality control purposes, your activity on this website may be monitored or recorded by Marketplace America or its service providers.