Always confirm your own deadline

These are the common federal windows. Your exact deadline can vary by plan and by state, and it is set by your plan documents. Check your denial letter and your Summary Plan Description (SPD) , and when in doubt, file early. Missing a deadline can forfeit your right to appeal.
Appeal typeFile withinDecision withinGuide
ERISA first internal appeal180 days of the denial30 days (post-service); 72 hours if urgentERISA
ERISA external review4 months of the final internal denial45 days; 72 hours if urgentERISA
ERISA federal court (after final denial)At least 1 year of the final decision (your SPD may allow longer)Set by the courtERISA
Urgent (expedited) appealAs soon as your physician certifies urgency72 hours (internal and external)Urgent ERISA
ACA internal appeal180 days of the denial30 to 60 days; 72 hours if urgentACA
ACA external review60 days of the final internal denial45 days; 72 hours if urgentACA
ACA eligibility appeal90 days of the eligibility noticeAbout 90 daysACA
Surprise bill dispute (No Surprises Act)120 days of the initial bill dateAbout 30 days (patient-provider dispute resolution)No Surprises Act
Out-of-network underpaymentYour plan's appeal window (often 180 days under ERISA)Varies by planOON underpayments

Disclaimer

This guide is for informational purposes only and does not constitute legal or medical advice. Appeal It Now provides administrative support and appeal preparation services only; we are not a law firm. Please consult a qualified professional for advice specific to your situation.

As of May 2026