Appeal deadlines in Massachusetts

State outside review (4 months); Medicaid hearing deadline 60 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 Massachusetts

Outside review: 4 months
Hearing deadline: 60 days
Then a state hearing: 120 days
Appeal deadline – Massachusetts Health Connector: 60 days

How each deadline is counted in Massachusetts

Time to file

You have 180 days from the date of the denial notice or Explanation of Benefits to ask your insurer for an internal appeal.

Law: Mass. Gen. Laws c. 176O, s. 13(a)-(c), s. 14(b)

How fast the plan must decide

Standard: 30 days

Deadline to ask

You must send your request to OPP within 4 months of receiving the final adverse determination letter.

Law: Mass. Gen. Laws c. 176O, s. 14; Mass. Gen. Laws c. 958 CMR 3.000

The deadline runs from

The date you receive the insurer's final adverse determination letter (the letter answering your internal appeal)

Hearing deadline

The date you received the written MassHealth notice. The Board of Hearings must receive your request by the deadline.

Keeping your benefits during the appeal

You keep your benefits during the appeal if the Board of Hearings receives your request before your benefits stop or within 10 calendar days of the date you received the notice, whichever is later.

How long do I have? Deadline calculator

Massachusetts · Appeal deadline calculator

If you miss a deadline

Medicaid

If you got no written notice, or MassHealth did not act on your application or request, you have 120 days from the date of the action or of the application or request (unless the Board of Hearings Director waives this limit).

Law: 130 CMR 610.015

Sources

The official sources for Massachusetts are listed on the Massachusetts 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?