Appeal deadlines in California

State outside review (6 months); Medicaid hearing deadline 90 days.

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.

Deadlines at a glance in California

Outside review: 6 months
Hearing deadline: 90 days
Then a state hearing: 120 days
Appeal deadline – Covered California: 90 days

How each deadline is counted in California

Time to file

State law does not set a shorter time. Use the deadline on your denial notice; federal rules give at least 180 days for most plans.

Law: Cal. Health & Safety Code 1368.01(a)-(b)

How fast the plan must decide

Standard: 30 days; Urgent: 3 days

Deadline to ask

You can apply within 6 months. The agency may allow more time if your circumstances warrant it.

Law: Cal. Health & Safety Code 1374.30-1374.36; Cal. Ins. Code 10169-10169.5

The deadline runs from

The plan's or insurer's final grievance decision (or the end of 30 days with no decision)

Hearing deadline

The date of the notice of action (the action you disagree with)

Keeping your benefits during the appeal

Your benefits continue while you wait for the hearing (Aid Paid Pending) if you ask for a hearing by the effective date of the change when a 10-day notice is required, or within 10 days of the date of the notice when it is not.

How long do I have? Deadline calculator

California · Appeal deadline calculator

If you miss a deadline

Medicaid

After 90 days you must show a good reason for filing late, such as illness or a disability. A hearing cannot be granted for good cause more than 180 days after the action.

Medicaid health plan (managed care) in California

A late request may be accepted for good cause, but not more than 180 days after the plan's notice.

Law: Cal. Welf. & Inst. Code 10951(b), 14197.3; Cal. Health & Safety Code 1374.30(f); Cal. Health & Safety Code 42 CFR 438.402

Medicaid

For eligibility-related hearings after a Medi-Cal renewal (redetermination), such as an end of Medi-Cal, a cut from full to limited benefits, or a higher share of cost, you have 120 days from the date the notice was mailed. This temporary extension started April 1, 2023 and stays in effect until further notice. It does not apply to new applications or to requests for a particular treatment or service.

Law: Cal. Welf. & Inst. Code 10951

Sources

The official sources for California are listed on the California page.

National rules that apply in every state

You have at least 180 days (about 6 months) from when you receive the denial notice to file an internal appeal. Your plan can give you more time, not less.

Law: 29 CFR 2560.503-1(h)(3)(i); 45 CFR 147.136(b)(2)(i), (b)(3)(i)

Under the federal process you have 4 months from the date you receive the denial or final appeal decision to ask for external review. If there is no matching date 4 months later, the deadline is the first day of the fifth month. If the last day is a Saturday, Sunday or federal holiday, it moves to the next business day. State programs must allow at least 4 months; some allow more.

Law: 45 CFR 147.136(c)(2)(vi), (d)(2)(i)

Your state must give you a reasonable time to ask for a fair hearing, up to 90 days from the date the notice was mailed. Check your notice: your state's deadline may be shorter.

Law: 42 CFR 431.221(d)

You generally have 90 days from the date of your Eligibility Notice to appeal. If you are late, explain why when you file; you may be able to get an extension.

Law: 45 CFR 155.520(b), (d)(2)(i)(D); HealthCare.gov, What can I appeal?