Claim Denial Appeal Deadline Calculator
Determine your internal and external appeal deadlines after receiving an insurance claim denial. Enter the denial date, insurance type, and your state to calculate key filing deadlines.
Date printed on the denial letter
Assumed mail delivery lag (default 3 days; adjust if known)
Formulas & Rules Applied
Receipt Date = Denial Notice Date + Mail Lag Days
Internal Appeal Deadline = Receipt Date + Plan-Type Days
External Review Deadline = Final Internal Denial Date + External Review Days
Days Remaining = Deadline Date − Today
| Plan Type | Internal Appeal | External Review | Expedited (Urgent) |
|---|---|---|---|
| ERISA Group Health | 180 days from receipt | 4 months from final denial | 72 hrs (plan decision) |
| ACA Marketplace | 180 days from receipt | 4 months from final denial | 72 hrs (plan decision) |
| Medicare Advantage | 60 days from denial | 60 days from reconsideration | 72 hrs (plan decision) |
| Medicare Part D | 60 days from denial | 60 days from redetermination | 24 hrs (plan decision) |
| Medicaid | 90 days (federal min.) | State Fair Hearing | Varies by state |
| Auto Insurance | 15–30 days (state law) | State DOI complaint | N/A |
| Property Insurance | 30 days (state law) | Appraisal / litigation | N/A |
Assumptions & References
- Mail lag: Federal regulations (e.g., 29 CFR 2560.503-1) presume receipt 5 days after mailing; this tool defaults to 3 days and allows adjustment.
- ERISA / ACA: 29 CFR 2560.503-1; 45 CFR 147.136; DOL Technical Release 2010-01; ACA §2719.
- Medicare Advantage: 42 CFR 422.562–422.626; CMS Medicare Managed Care Manual Ch. 13.
- Medicare Part D: 42 CFR 423.562–423.636; CMS Prescription Drug Benefit Manual Ch. 18.
- Medicaid: 42 CFR 431.200–431.250 (State Fair Hearings); state-specific rules vary.
- Auto / Property: State insurance codes and NAIC Unfair Claims Settlement Practices Model Act; statutes of limitations vary by state.
- External review deadlines shown are the claimant's filing deadline, not the reviewer's decision timeline.
- Deadlines falling on weekends or federal holidays may be extended to the next business day — verify with your plan or attorney.
- This calculator does not account for plan-specific shorter deadlines that may appear in your Summary Plan Description (SPD) or policy documents.
- This tool is for informational purposes only and does not constitute legal advice.