Medicaid appeals in Massachusetts: hearing deadline and keeping benefits

Medicaid (MassHealth) denials in Massachusetts

Medicaid agency

MassHealth (Executive Office of Health and Human Services, Office of Medicaid)

Who holds the hearing

Office of Medicaid, Board of Hearings (BOH)

Hearing deadline

60 days

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

Source: the notice is presumed received 5 days after its date

If you are late

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).

How to ask for a hearing

• Form: Fill out the Fair Hearing Request Form (English, Spanish and other languages) and send it with a copy of the notice you are appealing
• Mail: Board of Hearings, Office of Medicaid, One Enterprise Drive, 4th Floor, Quincy, MA 02171
• Fax: Board of Hearings fax (617) 887-8797
• Online: Email the form and notice to boh-fairhearingsrequest@mass.gov (MassHealth recommends password-protected attachments)
• Phone: MassHealth Customer Service Center, (800) 841-2900, TDD/TTY 711, can fill out the request with you by phone
• In person: Office of Medicaid, Board of Hearings, 1 Enterprise Drive, Quincy, MA 02171, 8:45 a.m. to 4:45 p.m.; bring the notice

www.mass.gov · (800) 841-2900

Mail address

Board of Hearings, Office of Medicaid, One Enterprise Drive, 4th Floor, Quincy, MA 02171

What to include

Your name, mailing address, phone number, member ID and date of birth; the reason for your appeal and why you are appealing, with supporting documents; whether you want to keep your benefits during the appeal; how you want the hearing held (in person, phone or video); any interpreter or accommodation you need; your appeal representative, if any; and your signature. Attach a copy of the notice.

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. Check the box on the form. If you lose, you may have to pay back the cost of the benefits you got during the appeal.

Law: MassHealth Fair Hearing Request Form (FHR-1, 2026-07); 130 CMR 610.036; 130 CMR 610.015

When the hearing is held

The Board of Hearings sends a notice with the hearing date, time and place at least 10 days before the hearing. The decision is due within 45 days for application denials and managed care appeals, and within 90 days for other appeals.

Law: 130 CMR 610.015(D)

Faster (expedited) hearing

In limited cases an expedited hearing may be provided; the Board of Hearings schedules it automatically when needed.

Law: 130 CMR 610.015

Medicaid health plan (managed care) in Massachusetts

Appeal to the plan first

If you are in a MassHealth managed care plan (for example an ACO or MCO), appeal to your plan first. If the plan's final internal appeal decision goes against you in whole or in part, ask the Board of Hearings for a fair hearing within 120 days of receiving it. The Board of Hearings must decide within 45 days, unless the plan appeal was expedited.

Then a state hearing

120 days

The date you receive the plan's final internal appeal decision

If the plan is late

If the plan does not decide your appeal on time, you have 120 days from the date the plan's deadline ran out to ask the Board of Hearings for a hearing.

Law: 130 CMR 610.015(B)(7), (D)(2)

Write my appeal: free letters

Letter: Medicaid fair hearing request