Anyone applying for or enrolled in Medicaid who thinks a decision to deny, suspend, end, or reduce their Medicaid eligibility or services is wrong has the right to ask for a fair hearing about that decision. A fair hearing is also known as an appeal.
Appealing Your HealthChoice Managed Care Organization's Decision
If you get your health care through a Medicaid managed care plan, you must first go through your plan’s appeal process before you can ask for a State fair hearing. You must contact your plan and follow their appeals’ process. You can find their contact information on the back of your member ID card, in your member handbook or on our HealthChoice web page. You must file an appeal with your plan within 60 days from the date on your denial notice. Your plan can help you file an appeal with them and give you information about any next steps. Do not use the form on this page to file an appeal.
Appealing All Other Decisions
You must ask for a fair hearing within 90 days from the date on your notice. However, if you have Medicaid coverage and want to keep it while your appeal is pending, you must appeal within 10 calendar days of the date on your notice, the postmark or the effective date of action whichever is later. For example, your notice has a date of June 20, a postmark of June 24 and your services have an effective end date of June 30, you must appeal within 10 days of June 30 to stay covered.
Submit a Fair Hearing Request
Use the online form to submit your request. You will get an email confirming we have received your form.
Mobile Viewers Only: Go to the mobile request form now.
