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Appeal deadlines
Deadlines are the difference between an appeal that counts and one that does not. Here are the filing windows and response times for each kind of appeal, in one place.
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 type | File within | Decision within | Guide |
|---|---|---|---|
| ERISA first internal appeal | 180 days of the denial | 30 days (post-service); 72 hours if urgent | ERISA |
| ERISA external review | 4 months of the final internal denial | 45 days; 72 hours if urgent | ERISA |
| ERISA federal court (after final denial) | At least 1 year of the final decision (your SPD may allow longer) | Set by the court | ERISA |
| Urgent (expedited) appeal | As soon as your physician certifies urgency | 72 hours (internal and external) | Urgent ERISA |
| ACA internal appeal | 180 days of the denial | 30 to 60 days; 72 hours if urgent | ACA |
| ACA external review | 60 days of the final internal denial | 45 days; 72 hours if urgent | ACA |
| ACA eligibility appeal | 90 days of the eligibility notice | About 90 days | ACA |
| Surprise bill dispute (No Surprises Act) | 120 days of the initial bill date | About 30 days (patient-provider dispute resolution) | No Surprises Act |
| Out-of-network underpayment | Your plan's appeal window (often 180 days under ERISA) | Varies by plan | OON 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