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

In Connecticut, your health plan is regulated by Connecticut Insurance Department (CID), Consumer Affairs Division, if it is a state-regulated plan.

Connecticut runs its own independent review of denials: External Review Program (Connecticut Insurance Department). You generally have 120 days 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.

HUSKY Health

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

Marketplace (Access Health CT) 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 Connecticut?

Appeal to your plan
At least 180 days from receipt of the denial (federal rule)
Outside review
120 days
Hearing deadline
60 days
Appeal deadline – Access Health CT
90 days

All the details →

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 Connecticut, is handled by the Connecticut Insurance Department. A self-insured employer plan is handled by the U.S. Department of Labor; self-insured government plans can use the state external review.

Law: Conn. Gen. Stat. 38a-591g(a)(3)

Step 1: Appeal to your plan in Connecticut

What it is called: Grievance (internal appeal) of an adverse determination

For a denial based on medical necessity, the carrier must decide within 30 calendar days for care not yet received or ongoing care, and 60 calendar days for care already received. An expedited (urgent) grievance must be decided within 48 hours (72 hours if part of the 48 hours falls on a weekend), and within 24 hours for certain substance use disorder and mental health care. You can ask for free copies of all documents and evidence about the denial.

Law: Conn. Gen. Stat. 38a-591e(b), (d); Conn. Gen. Stat. 38a-591n

All the details →

Step 2: Outside review in Connecticut

External Review Program (Connecticut Insurance Department)

Deadline to ask: 120 days.

All the details →

Urgent care in Connecticut: faster decisions

Appeal to your plan

  • Your plan must decide an urgent appeal within 48 hours.

Outside review

You can get an expedited review if waiting could seriously jeopardize your life or health or your ability to regain maximum function, if the denial concerns emergency care and you have not been discharged, or for experimental treatment your doctor certifies would be much less effective if not started promptly. The reviewer must decide within 48 hours (72 hours if part of that time falls on a weekend), within 24 hours for certain substance use disorder and mental health care, and within 5 calendar days for experimental or investigational treatment. Expedited review is not available for care already received.

Law: Conn. Gen. Stat. 38a-591g

Urgent: 48 hours

Complaints about your plan in Connecticut

For other problems with an insurance company, you can file a complaint with the Connecticut Insurance Department or ask its Consumer Affairs Division for help by phone or email (insurance@ct.gov).

portal.ct.gov

Medicaid (HUSKY Health (Connecticut Medicaid and CHIP)) denials in Connecticut

Who holds the hearing: DSS Office of Legal Counsel, Regulations and Administrative Hearings (OLCRAH).

Hearing deadline: 60 days

All the details →

Marketplace decisions in Connecticut

Marketplace

Access Health CT · 1-855-306-8625

Appeal deadline

90 days

The date of the eligibility notice

How to appeal

Access Health CT eligibility hearings are handled by the DSS Access Health CT-Health Exchange hearings unit. Follow the instructions on your eligibility notice. You can also ask for a hearing by phone at 1-855-306-8625 (860-424-4965 in the Hartford area; the 855 number is toll-free in Connecticut only), by fax to 860-424-4923, or by email to DSS-AHCT@ct.gov.

Law: 45 CFR 155.520(b)(1)

Other rights in Connecticut

Faster reviews for mental health and substance use care

For urgent requests for substance use disorder care, or for inpatient, partial hospitalization, residential or intensive outpatient mental health care, both the carrier's expedited grievance and the expedited external review must be decided within 24 hours.

Law: Conn. Gen. Stat. 38a-591a(38), 38a-591e(d)(1)(D), 38a-591g

Free copies of the denial file

On request, the carrier must give you free copies of all documents, communications, information and evidence about the denial that you did not already have, including citations to medical journals.

Law: Conn. Gen. Stat. 38a-591n

How long do I have? Deadline calculator

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

Good to know in Connecticut

  • Connecticut gives 120 calendar days (not 4 months) to ask the Insurance Department for external review.

    Law: Conn. Gen. Stat. 38a-591g(e)(1)

  • Connecticut's expedited external review must be decided within 48 hours, faster than the federal 72 hours.

    Law: Conn. Gen. Stat. 38a-591g

  • HUSKY gives 60 days to request a fair hearing, and benefits may continue if you ask before the proposed action date (DSS OLCRAH, Requesting a Hearing).

Changes in 2024–2026

The Insurance Department moved to 280 Trumbull Street, Floor 7, Hartford on September 8, 2026 and updated its external review form (dated 10/5/2026). The Office of the Healthcare Advocate suspended in-person visits from June 10, 2026 during a relocation. DSS has published information on the federal H.R. 1 HUSKY work rules.

Questions about appeals in Connecticut

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

You can file a grievance with your health carrier within 180 calendar days after you receive the denial notice, the same as the federal minimum. 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 Connecticut?

External Review Program (Connecticut Insurance Department). Send the Request for External Review form, completed and signed, with a copy of your ID card and a copy of the final denial letter, to Connecticut Insurance Department, Attn: External Review, P.O. Box 816, Hartford, CT 06142-0816 (overnight delivery: 280 Trumbull Street, 7th Floor, Hartford, CT 06103), or by email to externalreview@ct.gov or fax to 860-297-3872. Add any new medical information, such as a letter from your doctor.

Is outside review free in Connecticut?

The health carrier pays the cost of the independent review. Connecticut removed its external review filing fee in 2021.

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

60 days. The date of the DSS Notice of Action (state law: the request must be mailed within 60 days after the decision)

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

For HUSKY (Medicaid), your benefits may continue during the hearing if you request the hearing any time before the date of the proposed action.

How do I appeal a Marketplace decision in Connecticut?

Access Health CT eligibility hearings are handled by the DSS Access Health CT-Health Exchange hearings unit. Follow the instructions on your eligibility notice.

Not about a denied claim?

Nearby states

Sources

Sources