External review in Minnesota: deadline, cost and how to ask
Minnesota runs its own independent review of denials: External Review (External Appeal). You generally have 6 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.
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.
Step 2: Outside review in Minnesota
- Program
External Review (External Appeal)
- Who runs it
- Minnesota Department of Health, Managed Care Systems Section: HMO plans (fully insured plans issued by a Minnesota HMO)
- Minnesota Department of Commerce: Plans from insurance companies regulated by Commerce
- Deadline to ask
6 months
You must ask for external review within 6 months from the date of the plan's adverse determination. After 6 months, you can only file a complaint with the state agency.
- The deadline runs from
The date of the adverse determination (the plan's final decision)
- Do I have to appeal to my plan first?
In most cases you must finish the plan's complaint or appeal process first. You can skip it if the plan waives this, if the plan did not follow the rules or time limits, or if you ask for expedited external review at the same time as an expedited internal appeal.
- Cost
The health plan company pays the cost of the external review.
- What can be reviewed
Plan decisions on a health care service or claim that are partly or fully against you after the plan's complaint or appeal process, including medical necessity, experimental or investigational treatment, and certain out-of-network (nonparticipating provider) coverage decisions. Complaints about fraudulent marketing or agent misrepresentation do not qualify. Medical Assistance, MinnesotaCare and Medicare are not covered (they have their own appeals).
- Is the decision final?
The decision is binding on the health plan company and not binding on you. The plan can ask a court to review it only if the decision was arbitrary and capricious or an abuse of discretion.
- How to ask
For an HMO: file online on the MDH Managed Care Systems Portal (no login needed), or complete the MDH External Appeal form and email it to health.mcs@state.mn.us or mail it to Minnesota Department of Health, Managed Care Systems Section, P.O. Box 64975, St. Paul, MN 55164-0975. For an insurance company plan: send a written request to the Minnesota Department of Commerce, 85 7th Place East, Suite 280, Saint Paul, MN 55101 (consumer.protection@state.mn.us). The state assigns an independent review organization at random; you and the plan have 10 business days to send information you want considered. Someone you choose can help or represent you.
Law: Minn. Stat. 62Q.73; Minn. Stat. 62Q.71
- Forms and online request
- Phone
MDH 1-800-657-3916; Commerce 1-800-657-3602
Write my appeal: free letters
Sources
The official sources for Minnesota are listed on the Minnesota page.