How to appeal a health insurance denial in Minnesota
The short answer
Start with your plan’s own appeal. If the plan says no again, you can usually ask an independent reviewer to decide. Minnesota lets you ask an independent reviewer to decide, through Minnesota Department of Commerce (insurance companies); Minnesota Department of Health (HMOs). The deadline to ask: within six months from the date of the adverse determination.
Does this apply to you? State external review covers plans regulated by Minnesota: individual and Marketplace plans, and job-based plans your employer bought from an insurer. Many large employers are self-funded; their plans follow the federal external review process, and state law usually does not apply (29 CFR 2590.715-2719(c)(1)). Medicare, Medicaid, TRICARE and federal employee plans have their own appeals: see the plan guides.
External review in Minnesota
Within six months from the date of the adverse determination
Decision within 72 hours of the expedited request. Available if you request it together with an expedited internal appeal, if you are still in a facility after emergency care, or if the standard timeline would seriously jeopardize life, health or ability to regain maximum function.
Free (the $25 filing fee was repealed in 2024; the health plan pays)
State-regulated plans (insurance bought in Minnesota, including HMOs, or through an employer that buys insurance). Self-funded employer plans use the federal process.
The agency depends on the plan: HMO members file with the Department of Health, Managed Care Systems (online portal or health.mcs@state.mn.us, 800-657-3916); other insured plans file with Commerce (consumer.protection@state.mn.us, fax 651-539-0105; 800-657-3602 is the Greater Minnesota line, metro 651-539-1600). The decision binds the plan but not you; Medicare, Medical Assistance and MinnesotaCare are excluded.
Who to contact
Before external review: the internal appeal
External review usually comes after your plan’s own appeal. The deadline for that first appeal depends on the type of plan:
- Employer plan: 180 days from the day you receive the denial notice
- Marketplace plan: 180 days from the day you receive the denial notice
- Medicare Advantage: 60 days from when you receive the denial (counted as 65 days from the notice date)
- Medicare Part D: 60 days from when you receive the denial (counted as 65 days from the notice date)
- Original Medicare: 120 days from when you receive the notice (counted as 125 days from the notice date)
- Medicaid: 60 days from the date printed on the denial notice
- FEHB (federal employees): 6 months from the date of the denial notice
- TRICARE: Mail within 90 days after the date of the denial notice
Questions people ask
How long do I have to ask for an external review in Minnesota?
Within six months from the date of the adverse determination
Can I get a fast external review in Minnesota?
Decision within 72 hours of the expedited request. Available if you request it together with an expedited internal appeal, if you are still in a facility after emergency care, or if the standard timeline would seriously jeopardize life, health or ability to regain maximum function.
Does external review cost anything in Minnesota?
Free (the $25 filing fee was repealed in 2024; the health plan pays)
Do Minnesota’s rules apply to my job-based plan?
Only if the plan is fully insured, meaning your employer bought a policy from an insurance company. Self-funded employer plans generally follow the federal external review process instead. Your Summary Plan Description or HR benefits team can tell you which kind you have.
Sources
- Minn. Stat. §62Q.73 External review of adverse determinations (2026)
The enrollee must request external review within six months from the date of the adverse determination.
- MDH: HMO Enrollee External Appeals and Complaints
External appeal requests must be filed within six months of the decision you are appealing.
- Minn. Stat. §62Q.73 subd. 3(c)
The cost of the external review must be borne by the health plan company.
This page is general information about appeal rules in the United States. It is not legal or medical advice. Rules can change, and your plan’s documents and your denial letter control the dates that apply to you.