Health insurance or Medicaid said no in Arkansas? Deadlines and free help

In Arkansas, your health plan is regulated by Arkansas Insurance Department (AID), Consumer Services Division, if it is a state-regulated plan.

Arkansas runs its own independent review of denials: External Review. You generally have 4 months to ask for it.

External review means a doctor or reviewer outside your plan decides again. Internal appeal means your plan looks at its own decision again.

Pick your plan type

Which kind of coverage was denied? The plan type decides which rules and deadlines apply.

Insurance I bought or got through work

Your state insurance rules may apply. First appeal to your plan, then ask for an outside review.

My employer pays claims itself (self-funded)

Federal rules apply, and most state insurance laws do not. Free help comes from the U.S. Department of Labor.

Arkansas Medicaid

You ask the state for a fair hearing. In a Medicaid health plan, you usually appeal to the plan first.

Marketplace (HealthCare.gov) decision

A decision about whether you can buy a plan or get financial help is appealed to the Marketplace.

How long do I have?Urgent care: faster decisionWrite my appealFree help

Checked against official sources: October 30, 2026.

Appeal deadlines are strict. If you are near a deadline or your care is urgent, call free help today.

How long do I have in Arkansas?

Appeal to your plan
At least 180 days from receipt of the denial (federal rule)
Outside review
4 months
Hearing deadline
30 days
Appeal to the plan first
60 days (federal rule)
Then a state hearing
120 days
Appeal deadline – HealthCare.gov
90 days (federal rule)

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How long do I have? Deadline calculator

How do I know which plan type I have?

How to tell which agency regulates your plan

Insurance you bought yourself, or got from an employer that does business only in Arkansas, is handled by the Arkansas Insurance Department. If your coverage is a self-funded (self-insured) employer plan, it usually is not eligible for the state external review; contact the U.S. Department of Labor and check with your employer.

Step 1: Appeal to your plan in Arkansas

What it is called: Internal appeal with your health carrier

Follow your carrier's internal appeal process first. If the carrier does not give you a written decision within 30 days for a pre-service claim or 60 days for a post-service claim after you file your appeal (unless you agreed to a delay), you are treated as having finished the internal appeal and can ask for external review.

Law: AID Rule 76 (23 CAR pt. 117), Section 7(A)(2)

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Step 2: Outside review in Arkansas

External Review

Deadline to ask: 4 months.

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Urgent care in Arkansas: faster decisions

Outside review

Expedited review is available if your treating health care provider certifies that waiting for the standard review would seriously jeopardize your life or health or your ability to regain maximum function, or, for experimental treatment, that it would be much less effective if not started promptly. Your provider fills out the AID physician certification form. The reviewer must decide within 72 hours, with written confirmation within 48 hours if the first notice was not in writing.

Law: AID Rule 76 (23 CAR pt. 117), Arkansas External Review Rule, Sections 4-11, 16

Complaints about your plan in Arkansas

For other problems with an insurance company or HMO, you can file a complaint with the Arkansas Insurance Department using its consumer complaint form, or contact Consumer Services by phone or email (insurance.consumers@arkansas.gov).

insurance.arkansas.gov

Medicaid (Arkansas Medicaid (including ARKids First and ARHOME)) denials in Arkansas

Who holds the hearing: Arkansas DHS Office of Appeals and Hearings.

Hearing deadline: 30 days

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Marketplace decisions in Arkansas

Arkansas uses HealthCare.gov. Appeals go to the federal Marketplace Appeals Center.

HealthCare.gov

1-855-231-1751

Other rights in Arkansas

Medicaid work requirement (ARHOME)

ARHOME adults aged 19 to 64 who are not exempt must work, volunteer or go to school at least 80 hours a month. DHS began a soft launch on July 1, 2026 with status notices but no penalties. From January 1, 2027, people who do not meet it will have 30 days to show compliance before Medicaid is suspended, and applications can be denied.

Law: Arkansas DHS news release, February 23, 2026

How long do I have? Deadline calculator

Pick your plan type and enter the dates on your notice. We count from the rules in Arkansas and the federal rules.

Worked out in your browser. Nothing you enter here is saved or sent.

If you are not sure when it arrived, use the date printed on the notice. That date is never later than the day it arrived.

Choose what was decided and enter the date on your notice

We add the number of days or months from the law to your date. Nothing is saved.

Write my appeal: free letters

Free help in Arkansas

Good to know in Arkansas

  • Arkansas Medicaid gives only 30 calendar days to request a fair hearing, counted from the date on the letter, and the request must be received in that time (DHS, File an Appeal).
  • To keep Medicaid during the appeal, DHS must receive your request within 10 calendar days of the date on the letter.

Changes in 2024–2026

Arkansas DHS started a soft implementation of the ARHOME work and community engagement requirement on July 1, 2026 (notices only, no penalties); full enforcement starts January 1, 2027 (DHS news release, February 23, 2026). The AID external review request form was revised in August 2024 (AID-CS-ER Rev. 8/24). From April 1, 2025, AID uses a new fax number (501-371-2734) and email (insurance.externalreview@arkansas.gov) for external review requests (AID Bulletin No. 5-2025).

Questions about appeals in Arkansas

How long do I have to appeal a health insurance denial in Arkansas?

Arkansas law does not set a longer time. Use the deadline on your denial notice; federal rules give at least 180 days for most plans. You have at least 180 days (about 6 months) from when you receive the denial notice to file an internal appeal.

How do I get an outside (external) review in Arkansas?

External Review. Fill out, sign and date the AID External Review Request Form (AID-CS-ER), which includes a release of medical records, and attach a copy of the denial. For an expedited review, also send the Physician Certification form signed by your treating provider.

Is outside review free in Arkansas?

The health carrier pays the cost of the independent review organization.

How long do I have to ask for a Medicaid fair hearing in Arkansas?

30 days. The date on the notice letter (the Office of Appeals and Hearings must RECEIVE your request within 30 calendar days)

Can I keep my Medicaid benefits while I appeal in Arkansas?

To keep your Medicaid until the hearing, the Office of Appeals and Hearings must receive your appeal and your request to continue benefits no later than 10 calendar days from the date on your letter. For some long-term services (such as ARChoices, nursing home, TEFRA and certain waivers) benefits stay on unless you say you do not want them.

Who regulates health insurance in Arkansas?

Arkansas Insurance Department (AID), Consumer Services Division. Insurance you bought yourself, or got from an employer that does business only in Arkansas, is handled by the Arkansas Insurance Department. If your coverage is a self-funded (self-insured) employer plan, it usually is not eligible for the state external review; contact the U.S. Department of Labor and check with your employer.

Not about a denied claim?

Nearby states

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