Appeal deadlines in New York

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 New York

Outside review
4 months
Hearing deadline
60 days
Then a state hearing
120 days
Appeal deadline – NY State of Health
60 days

How each deadline is counted in New York

Time to file

New York law requires plans to give you at least 45 days to file a standard appeal. Federal rules give at least 180 days for most plans. The deadline that applies to you is on your denial notice.

Law: N.Y. Ins. Law 4904(b), (c)

How fast the plan must decide

Standard: 30 days

Deadline to ask

You have 4 months to apply. If your plan offers a second-level internal appeal, you do not have to use it; if you do, the 4 months still run from the first appeal decision. If DFS does not receive your application within 4 months, you cannot get an external appeal. A provider appealing on its own behalf has 60 days.

Law: N.Y. Ins. Law 4910, 4914

The deadline runs from

The date you receive the plan's final adverse determination (or the date you and the plan agreed to skip the internal appeal)

Hearing deadline

The date of the action or notice you disagree with.

Keeping your benefits during the appeal

If the agency had to give you advance notice, your Medicaid continues unchanged until the hearing decision (aid continuing) if you ask for a fair hearing before the effective date of the action on your notice.

If you miss a deadline

Medicaid

For NY State of Health notices, if you ask after 60 days the Appeals Unit will ask you to give a good cause reason for the late request.

Law: N.Y. Soc. Serv. Law 22(4)(a); N.Y. Soc. Serv. Law 18 NYCRR 358-3.5, 358-3.6; DOH notice OHIP-3868

Sources

The official sources for New York are listed on the New York page.