State Appeal Guides
Health Insurance Appeal Help by State
Appeal deadlines, external-review rights, and state insurance-department complaint processes differ by state. Choose yours for a guide with the citations that apply where you live.
Free, always. No account. You review every word before you send it — and we never send anything to your insurer. You do.
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Quick Answer
Health-insurance appeal rules vary by state. Employer and individual plans must give you at least 180 days from the denial to file an internal appeal (29 CFR 2560.503-1(h)(3)(i); 45 CFR 147.136(b)(3)), after which you can request an external/independent review that is typically binding on the insurer. Pick your state below for its specific deadline, external-review path, and insurance-department complaint process. AppealArmor drafts your appeal letter from your denial, free, and its Next Steps sheet tells you where to send it and how to reach your state regulator.
State law your appeal letter can cite
We have 98 provisions of state law on file for 50 states and the District of Columbia: 49 on external review, 49 on step therapy. Where one applies to your plan, AppealArmor can cite it in your letter, quoting the provision or summarising it, with its citation and a link to the official source. The letter can cite 92 of them, in 48 states and the District of Columbia; the other 6 depend on a condition AppealArmor cannot check from your answers, so they go on your Next Steps sheet only. A provision is used only when your plan is one it covers (state insurance law generally does not reach self-funded employer plans, Medicare or Medicaid) and, for step therapy, only when your denial is about step therapy.
Open your state below to read its provisions and exactly when each is used. The same data is a public dataset for researchers and AI agents: /data/state-law.json (JSON, 98 rows, with citation, quote, source URL, plan types, conditions and whether the letter can quote the row).
Choose Your State
California
CAAppeal a denial in California: 180-day deadline, DMHC/CDI complaint, and binding Independent Medical Review.
Internal appeal deadline: 180 days
Texas
TXAppeal a denial in Texas: 180-day deadline, TDI complaint process, and Independent Review Organization rights.
Internal appeal deadline: 180 days
Florida
FLAppeal a denial in Florida: 180-day deadline, OIR complaint process, and external review rights.
Internal appeal deadline: 180 days
New York
NYAppeal a denial in New York: 180-day deadline, DFS complaint process, and external appeal rights.
Internal appeal deadline: 180 days
Pennsylvania
PAAppeal a denial in Pennsylvania: 180-day deadline, PID complaint process, and external review rights.
Internal appeal deadline: 180 days
Illinois
ILAppeal a denial in Illinois: 180-day deadline, DOI complaint process, and external review rights.
Internal appeal deadline: 180 days
Ohio
OHAppeal a denial in Ohio: 180-day deadline, ODI complaint process, and external review rights.
Internal appeal deadline: 180 days
Georgia
GAAppeal a denial in Georgia: 180-day deadline, OCI complaint process, and external review rights.
Internal appeal deadline: 180 days
North Carolina
NCAppeal a denial in North Carolina: 180-day deadline, DOI complaint process, and Smart NC external review.
Internal appeal deadline: 180 days
Michigan
MIAppeal a denial in Michigan: 180-day deadline, DIFS complaint process, and external review rights.
Internal appeal deadline: 180 days
These 10 states have in-depth guides with state-specific citations. Every other state has a guide below covering your federal appeal rights and your state insurance regulator — start your appeal here.
All 50 States + D.C.
Every state guide explains the federal appeal and external-review process that applies nationwide, links your state's insurance regulator, and reminds you to confirm your exact deadline. States marked Guide have an in-depth, state-specific write-up.
Fight Your Denial With State-Specific Citations
Upload your denial letter and get an appeal letter that cites the federal appeal rules for your plan, plus your state's law where it applies to your plan, and a Next Steps sheet with where to send it and how to reach your state regulator.
Start my appealFree, always. No account. You review every word before you send it — and we never send anything to your insurer. You do.