What is an appeal?
If you wish to have your eligibility determined by the Marketplace reviewed, you may submit a formal request, known as an appeal. Appeals can be requested for yourself or any member in your household who was also an applicant for health insurance in the Marketplace. Once an appeal has been requested, a hearing will be scheduled by the Marketplace. A hearing is where you will explain your disagreements with the Marketplace regarding health insurance.
Where do I go to appeal?
The Marketplace will not directly accept your appeals about health care services. Medicaid members can contact the Office of Administrative Hearings at www.otda.ny.gov/oah
or call 1.800.342.3334. Child Health Plus members or those enrolled in a qualified health plan, contact your health plan 1.800.809.4073
Are there time limits to file an appeal request?
The time limit for requesting an appeal is 60 days. The Marketplace will review your appeal request once received and follow up with you to discuss the next steps.
What do I do if I no longer want to appeal?
It is possible for you to withdraw if you decide the appeal is no longer necessary. You can call the Marketplace at 1.855.355.5777 to find out more about the withdrawal process.