Medicaid appeals in Nebraska: hearing deadline and keeping benefits

Medicaid (Nebraska Medicaid (Heritage Health managed care)) denials in Nebraska

Medicaid agency

Nebraska Department of Health and Human Services (DHHS), Division of Medicaid and Long-Term Care

Who holds the hearing

Nebraska DHHS Hearing Office

Hearing deadline

90 days

The date the Notice of Action is mailed

How to ask for a hearing

• Form: DHHS Request for Fair Hearing / Appeal
• Online: Email the request to DHHS.Hearingoffice@nebraska.gov
• Mail: DHHS Hearing Office, PO Box 98914, Lincoln, NE 68509-8914
• Fax: (402) 742-2376

public-dhhs.ne.gov · 402-471-7237

Mail address

Nebraska Department of Health and Human Services, Hearing Office, PO Box 98914, Lincoln, NE 68509-8914

What to include

Your name, date of birth, Social Security or Medicaid ID number, mailing address and phone; the program (Medicaid/Medical Assistance) and the specific reason you disagree; the date on the Notice of Action or Notice of Decision (attach a copy if you can), or the date of your application if you got no notice; whether you want an expedited appeal and why; whether you want your benefits to continue; any interpreter or other accommodation you need; and your representative's name and contact details, with a power of attorney or guardianship order if needed. Sign and date the form.

Keeping your benefits during the appeal

If you ask for a fair hearing before the effective date on your Notice of Action, your Medicaid continues until the hearing decision unless you say you do not want it. If you did not get timely notice, your Medicaid can be reinstated if you ask for a hearing within 10 days after you receive the notice. Check the box on the DA-6 form. If you lose, you may have to pay back the cost of the benefits you received during the appeal.

Law: 477 NAC 10-004, 10-005 (amended 7/29/2020); 465 NAC 2-002.03(A); DHHS form DA-6 (Rev. 6/2026); 477 NAC 10-003 (amended 7/29/2020); DHHS Request for Fair Hearing / Appeal (DA-6)

Source: counted as 5 days after the date on the notice

Faster (expedited) hearing

You can ask for a faster (expedited) appeal on the DA-6 form if waiting could risk serious health problems or death, or limit your ability to attain, maintain or regain maximum function. Explain why on the form.

Law: 477 NAC 10-003 (amended 7/29/2020); 465 NAC 2-002.03; DHHS Request for Fair Hearing / Appeal (DA-6)

Medicaid health plan (managed care) in Nebraska

Appeal to the plan first

Heritage Health members first appeal a plan's denial to the health plan (or the Dental Benefits Manager for dental care), following the plan's notice. Under Nebraska's rule, an appeal made by phone must be followed by a written, signed appeal. After you get the plan's appeal decision, you can ask for a state fair hearing in writing within 120 days from the date of the plan's notice of resolution. To keep your services during the plan appeal, file on or before the later of 10 calendar days after the plan mailed its notice or the date the change takes effect.

Then a state hearing

120 days

The date of the health plan's (or Dental Benefits Manager's) notice of appeal resolution

Law: 482 NAC 7-004 (Heritage Health rights and responsibilities, eff. 1/27/2020); 42 CFR 438.402, 438.408, 438.420

Write my appeal: free letters

Letter: Medicaid fair hearing request