Medicaid appeals in Wisconsin: hearing deadline and keeping benefits
Wisconsin Medicaid and BadgerCare Plus (ForwardHealth): you have 45 days to ask for a fair hearing.
If DHA receives your hearing request before the agency's action takes effect, your Medicaid will not stop or be reduced while the hearing is pending.
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.
Medicaid (Wisconsin Medicaid and BadgerCare Plus (ForwardHealth)) denials in Wisconsin
- Medicaid agency
Wisconsin Department of Health Services (DHS), with county and tribal income maintenance (IM) agencies
- Who holds the hearing
Wisconsin Department of Administration, Division of Hearings and Appeals (DHA)
- Hearing deadline
45 days
The effective date of the action (DHA must receive your request within 45 days)
- How to ask for a hearing
- Form: DHA Request for Fair Hearing form (DHA-28, in English and 9 other languages) or a signed letter. DHA says Medicaid requests must be in writing and signed.
- Mail: Division of Hearings and Appeals, P.O. Box 7875, Madison, WI 53707-7875
- Fax: (608) 264-9885
- Email: DHAMail@wisconsin.gov
- In person: Your local county or tribal agency can help you ask for a hearing
- Mail address
Division of Hearings and Appeals, P.O. Box 7875, Madison, WI 53707-7875
- What to include
Your name and mailing address, a brief description of why you want a hearing, the county or state agency that took the action or denied the service, a copy of the notice, your case (CARES) number if you have one, and your signature. DHA does not accept unsigned requests.
- Keeping your benefits during the appeal
If DHA receives your hearing request before the agency's action takes effect, your Medicaid will not stop or be reduced while the hearing is pending. Tell DHA in your request if you do not want benefits to continue. If you lose, you may have to repay benefits you should not have received.
Law: BadgerCare Plus Handbook 29.2.4; DHS F-10151; Wis. Stat. 49.45(5)
- When the hearing is held
DHA sends a notice of the hearing at least 10 days before it. DHA must hold the hearing and issue a decision, and the agency must carry it out, within 90 days of the date DHA receives the request.
Law: BadgerCare Plus Handbook 29.2.3, 29.2.6; Wis. Stat. 49.45(5)
- Faster (expedited) hearing
For Medicaid managed care service denials, a hearing request on a denial of an expedited (urgent) appeal must be decided within 3 working days of receipt. DHA also expedites requests from people who plan to move out of Wisconsin before a decision would normally be issued.
Law: Wis. Stat. 49.45(5); BadgerCare Plus Handbook 29.2
Medicaid health plan (managed care) in Wisconsin
- Appeal to the plan first
If you are in a BadgerCare Plus or Medicaid SSI HMO, appeal to the HMO within 60 calendar days of the date on the denial notice. The HMO must decide within 30 calendar days (72 hours if expedited). If the HMO upholds the denial, request a state fair hearing with DHA within 90 days. To keep services during the HMO appeal, ask within 10 calendar days of the HMO sending its notice. You can get help from the HMO's member advocate or the state's Ombuds.
- Then a state hearing
90 days
The date you receive the HMO's notice upholding its decision
Source: receipt is presumed 5 days after the notice date
- If the plan is late
If the HMO does not decide your appeal on time, you are treated as having finished the HMO's appeal process and can ask for a state fair hearing; the 90 days then run from the date the HMO failed to act.
Law: Wis. Stat. 49.45(5)(ag)
Write my appeal: free letters
Sources
The official sources for Wisconsin are listed on the Wisconsin page.