Insurance Appeal Deadlines by Company: Complete 2025 Filing Guide

Why Insurance Appeal Deadlines Matter

Missing your appeal deadline is the #1 reason valid claims never get reviewed. Insurance companies strictly enforce these deadlines—appeals submitted even one day late are automatically rejected without consideration of merit.

Here's the critical fact most practices don't know: 82% of properly appealed denials are overturned, but only 11% of denials ever get appealed. Most of those 89% who never appeal miss their deadline or don't realize they have appeal rights.

The financial impact:

• Average denied claim value: $3,500-$8,000
• Practices that miss appeal deadlines lose: $25,000-$75,000 annually in recoverable revenue
• Time wasted on late appeals (auto-rejected): 45 minutes per denial

This guide provides the exact filing timeline for every major insurance company so you never miss another appeal deadline.

Insurance Appeal Deadlines: Complete Comparison Table

This table shows how long you have to file an internal appeal after receiving a denial notice, by insurance company and plan type:

Key Takeaway: Most commercial plans allow 180 days, but UnitedHealthcare's 65-day deadline is significantly shorter. All Medicare Advantage plans (regardless of insurer) follow CMS guidelines: 60 days.

Detailed Appeal Deadlines by Insurance Company

Aetna Appeal Deadlines

Standard Commercial Plans: 180 calendar days from denial date

How Aetna Calculates Deadlines:

• Starts: Date on denial letter (not date received)
• Ends: 180 calendar days later (not business days)
• No automatic extensions
• Late appeals automatically rejected

Special Considerations:

• State exceptions apply for fully insured plans (California, New York, Texas have variations)
• Provider contracts may allow additional time (check your specific agreement)
• "Good cause" exceptions rarely granted

Where to File:

• Online (fastest): Aetna.com provider portal via Availity
• Mail: Aetna Appeals Department, P.O. Box 14463, Lexington, KY 40512-4463
• Fax: 1-859-425-3379 (Standard), 1-859-425-3380 (Expedited)

Decision Timeline:

• Standard appeals: 30 calendar days
• Expedited appeals: 72 hours
• Failure to decide within timeline = automatic approval (federal law)

→ Read Full Aetna Appeal Guide

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Blue Cross Blue Shield Appeal Deadlines

Standard Plans: 180 days from denial notification

BCBS Special Challenge: BCBS is actually 34 independent companies with different policies. Your deadline depends on which BCBS company insures you:

How to Identify Your BCBS Company:

• Check your ID card for company name (Anthem, Premera, Horizon, etc.)
• Using wrong company's policies = automatic denial
• Each company has different medical policies and CPB numbers

Decision Timeline:

• Standard appeals: 30 days
• Urgent appeals: 72 hours
• Some states require 15 days (faster than federal minimum)

For a complete guide to appealing Blue Cross Blue Shield denials, see our comprehensive BCBS appeal guide.

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UnitedHealthcare Appeal Deadlines

ALL Plans: 65 calendar days from denial date

This is significantly shorter than most insurers. Don't assume you have 180 days.

How UHC Calculates Deadlines:

• Starts: Date on initial determination notice
• Ends: 65 calendar days later
• Applies to: Commercial, Medicare Advantage, Medicare Part D, Reimbursement requests

Extension Possible:

• UHC "may" grant extension if you have good reason
• Must request extension BEFORE deadline expires
• Good reasons: serious illness, hospitalization, administrative error by UHC

Where to File:

• Online: UHCprovider.com portal (most network providers required to file electronically)
• Mail: Address varies by plan type (see denial letter)
• Phone: 1-866-480-1086

Decision Timeline:

• Standard appeals: 7 calendar days (fastest among major insurers)
• Expedited appeals: 72 hours
• Part D drug appeals: 7 days (not received drug), 14 days (reimbursement)

UHC-Specific Tip: UHC's fast 7-day decision timeline means you get results quickly—but the shorter 65-day filing window means you must act fast.

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Cigna Appeal Deadlines

Standard Plans: 180 calendar days from initial denial or payment date

Provider-Specific Deadlines:

• Payment reviews: 180 days from initial payment or denial
• Payment adjustments: 180 days from last payment adjustment date
• Second-level appeals (Cigna HealthCare for Seniors): 60 days from first-level decision

Where to File:

• Online: MyCigna.com provider portal
• Mail: Address on denial letter (varies by region)
• Fax: See denial letter

Decision Timeline:

• Pre-service medical necessity: 30 days
• Post-service medical necessity: 30 days
• Post-service administrative: 60 days
• Expedited appeals: 72 hours

Cigna-Specific Advantage: Cigna's peer-to-peer (P2P) process often resolves denials same-day. Request P2P immediately after denial (before formal appeal) for fastest resolution.

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Humana Appeal Deadlines

Commercial Plans: 180 days

Medicare Advantage: 65 days from denial notice

Medicaid Plans: 60 days (Kentucky, Florida, Illinois)

Where to File:

• Online: Humana.com/resolutions (online appeal form)
• Phone: Customer Care number on back of ID card
• Mail/Fax: See denial notice

Decision Timeline:

• Standard appeals: 30 days
• Expedited appeals: 72 hours
• Medicaid appeals: Varies by state (typically 30 days)

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Premera Blue Cross Appeal Deadlines

Standard Plans: 180 days from EOB or adverse decision date

Heritage Plans (Special): 365 days from Premera action date

This is the longest appeal deadline among major insurers.

Important Distinctions:

• Initial claims: Must be filed within 365 days of service date
• Corrected claims: 180 days from service date
• Appeals (first level): 180 days from EOB/denial
• Appeals (second level): 180 days from first-level decision
• Heritage plan first-level appeals: 365 days

Where to File:

• Mail: Premera Appeals Department, P.O. Box 91102, Seattle, WA 98111-9202
• Fax: (425) 918-5592
• Online: Premera provider portal

Decision Timeline:

• Standard appeals: 30 days
• Heritage plan appeals: 30 days
• Expedited appeals: 72 hours

Premera-Specific Tip: Heritage plans (older legacy plans) have significantly longer filing windows. Check your plan type before calculating deadline.

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Decision Timeline Comparison: How Long Until You Get an Answer

Once you file your appeal, how long does the insurance company have to decide? Here's the comparison:

Federal Law Protection: Under 29 CFR 2560.503-1, if your insurance company fails to respond within their required timeframe, your appeal is automatically approved or you're deemed to have "exhausted" internal appeals and can move directly to external independent review.

Expedited Appeals: When You Need a 72-Hour Decision

For prior authorization denials specifically, see our complete guide to prior authorization denial reasons and appeal strategies including expedited review criteria.

What Qualifies as "Urgent"

Your situation qualifies for expedited review (72-hour decision) if:

1. Life-threatening: Standard timeline could seriously jeopardize your life or ability to regain maximum function
2. Severe pain: You're experiencing severe pain that cannot be adequately managed without the treatment
3. Ongoing treatment: You need immediate decision for ongoing course of treatment (hospital stay, infusion series)
4. Emergency: You already received emergency treatment and need retroactive authorization

2025 Expanded Definitions

Many states have expanded what counts as "urgent" beyond immediately life-threatening:

• Severe pain affecting daily function
• Risk of disability or permanent harm
• Inability to work or perform daily activities
• Mental health crisis situations

Important 2025 Change: Expedited timelines have shortened from 72 hours to 24-48 hours in most jurisdictions, with penalties up to $10,000 per day for delays.

How to Request Expedited Appeal

In your appeal letter, include this language:

I am requesting EXPEDITED review under [Insurance Company]'s urgent appeal
procedures per [State] regulations and federal law. Delay in receiving
[specific treatment] will seriously jeopardize my health because [specific
medical harm with timeline]. My physician's statement documenting urgent
medical need is attached.

Required Documentation:

• Physician statement explaining urgent medical need
• Specific harm that will occur from delay (with timeline)
• Why treatment cannot wait 30 days

Filing Methods:

• Call insurance company immediately (fastest)
• Email or fax appeal with "EXPEDITED" in subject line
• Online portal submission with expedited box checked

State-Specific Appeal Deadline Variations

While federal law sets minimum standards, some states have shorter appeal deadlines or additional protections:

Critical State Law Principle: When state law is MORE protective than federal law, state law applies. When federal law is more protective, federal law applies. You get whichever deadline is LONGER (more time to appeal).

How to Check Your State's Laws

1. Read your denial letter carefully—it must state your appeal rights and deadlines under both state and federal law
2. Contact your state insurance commissioner's office
3. Check [State Insurance Department Website] for patient appeal guides
4. Consult your state's Department of Insurance consumer assistance line

What Happens If You Miss Your Appeal Deadline

Automatic Rejection

If you file your appeal even one day late, most insurance companies will:

1. Reject the appeal without reviewing the merits
2. Send you a letter stating "appeal filed outside allowable timeframe"
3. Close your case permanently
4. Make the original denial final and binding

You typically cannot:

• Sue the insurance company (ERISA plans require exhausting appeals first)
• File external review (must complete internal appeals within deadline)
• Request reconsideration (deadline is strictly enforced)

"Good Cause" Exceptions

Insurance companies and Medicare may accept late appeals if you demonstrate "good cause" for missing the deadline.

Examples of Good Cause:

✅ Accepted Reasons:

• You were seriously ill and physically unable to file (hospitalized, ICU, surgery)
• Death or serious illness in immediate family
• Natural disaster destroyed records or prevented filing (hurricane, fire, flood)
• Insurance company gave you incorrect deadline information (documented)
• You never received the denial notice (proof required)
• Physical, mental, educational, or language limitations prevented understanding
• Insurance company administrative error caused delay

❌ NOT Good Cause:

• "I was busy" or "I forgot"
• "I didn't think it would be approved"
• "My staff didn't tell me about the denial"
• Vacation or travel
• Waiting to gather documentation
• Didn't understand the process (without proof of disability/language barrier)

How to Request Good Cause Exception

Act immediately: The longer past the deadline, the less likely good cause is granted.

Include in your late appeal:

GOOD CAUSE REQUEST FOR LATE FILING

I am requesting good cause consideration for filing this appeal [X] days
past the deadline due to [specific circumstance]. Supporting documentation
is attached:

[Describe circumstance with specific dates]
[Explain why you couldn't file on time]
[Document when you discovered you missed deadline and filed immediately]

I request the insurance company waive the deadline and review the appeal
on its merits.

Attach Documentation:

• Hospital admission/discharge records (if hospitalized)
• Death certificate (if family member died)
• Insurance company correspondence showing wrong information
• Proof you never received denial (certified mail receipt, etc.)

Success Rate: Good cause exceptions are granted in approximately 15-25% of cases where strong documentation exists.

How to Calculate Your Exact Appeal Deadline

Step-by-Step Calculation:

Step 1: Find the date on your denial letter

• Look for: "Date of Determination," "Date of Decision," or "Notice Date"
• This is Day 0 (not Day 1)

Step 2: Determine your insurance company's deadline

• Aetna/BCBS/Cigna/Premera: 180 days
• UnitedHealthcare: 65 days
• Medicare Advantage (all): 60 days
• Check table above for your specific insurer

Step 3: Count calendar days (not business days)

• Include weekends
• Include holidays
• If final day falls on weekend/holiday, deadline is next business day

Step 4: File BEFORE the deadline

• If deadline is March 30th, file by March 29th to be safe
• Postmark date counts if mailing (use certified mail)
• Online submission timestamp must be before midnight on deadline day

Example Calculation:

• Denial date: October 1, 2025
• Insurance: Aetna (180 days)
• Deadline calculation: October 1 + 180 days = March 30, 2026
• Safe filing: File by March 29, 2026

Pro Tip: Don't wait until day 179. File within 30 days of denial for fastest processing and to avoid any deadline confusion.

Appeal Deadline Tracking Tools

Manual Tracking System

Create a simple tracking spreadsheet:

| Patient Name | Insurance | Denial Date | Deadline | Days Remaining | Status | |--------------|-----------|-------------|----------|----------------|--------| | J. Smith | Aetna | 10/1/25 | 3/30/26 | 120 | Researching | | M. Jones | UHC | 10/5/25 | 12/9/25 | 45 | Ready to file |

Automated Tracking with Muni

Muni Appeals automatically tracks all your appeal deadlines and sends alerts:

Automatic Deadline Calculation:

• Identifies insurance company from denial letter
• Calculates exact deadline based on company and plan type
• Adjusts for state-specific variations

Proactive Alerts:

• 90 days before deadline: "Low priority—plenty of time"
• 60 days before deadline: "Medium priority—start gathering documentation"
• 30 days before deadline: "High priority—file within 2 weeks"
• 14 days before deadline: "URGENT—file immediately"
• 7 days before deadline: "CRITICAL—deadline approaching"

Results:

• Zero missed deadlines (from deadline tracking errors)
• Average filing time: 22 days from denial (vs. 67 days manually)
• $0 in lost revenue from late appeals

→ Try 3 Free Appeals with Automatic Deadline Tracking

Internal vs. External Appeal Deadlines

Understanding both timelines is critical:

Internal Appeals (First Step)

Definition: Submitted to the insurance company for review by their medical director

Deadlines:

• File within: 60-180 days (varies by insurer, see table above)
• Decision within: 7-30 days (standard), 72 hours (expedited)

Must complete internal appeals before external (with rare exceptions for urgent cases).

External Appeals (Second Step)

Definition: Submitted to independent third-party medical reviewer (not employed by insurance company)

When Available:

• Internal appeal denied
• Insurance company missed internal appeal deadline
• Urgent situation (can file simultaneously with internal)

Deadlines to File External Appeal:

External Review Success Rate: ~40% of external reviews overturn insurance denials (lower than internal 82%, but still significant)

Frequently Asked Questions

How do I know if my appeal deadline is 60, 65, or 180 days?

Your deadline depends on three factors: (1) Your insurance company (see table above), (2) Your plan type (commercial vs. Medicare Advantage vs. Medicaid), and (3) Your state (some states have shorter requirements). The fastest way to confirm is to read your denial letter—federal law requires insurers to clearly state your appeal deadline and rights.

What if my denial letter doesn't list an appeal deadline?

Federal law (29 CFR 2560.503-1) requires all denial notices to include: reason for denial, appeal deadline, and instructions for filing. If this information is missing, the insurance company violated procedural requirements. File your appeal immediately and note in your appeal letter that "denial notice failed to include required appeal rights information." You may also file a complaint with your state insurance commissioner.

Can I request an extension if I need more time to gather documentation?

Most insurance companies do not grant deadline extensions except for "good cause" (serious illness, hospitalization, etc.). However, you can file your appeal by the deadline with the documentation you have, then submit supplemental documentation within 10-15 days. Include a cover letter stating: "Initial appeal submission to meet deadline. Supplemental documentation to follow by [date]."

Does the appeal deadline restart if the insurance company requests more information?

No. The original deadline does not restart or pause when the insurer requests additional information. Your appeal must be initially filed by the original deadline. When they request more information during review, they typically give you 10-15 days to respond, but this is separate from the initial filing deadline.

What's the difference between the appeal deadline and the claims filing deadline?

Claims filing deadline (timely filing): How long you have to submit the initial claim for payment (typically 90-365 days from date of service). Appeal filing deadline: How long you have to appeal a denial after receiving the denial notice (typically 60-180 days from denial date). These are two separate deadlines. You can miss the claims filing deadline (claim denied) but still appeal within the appeal deadline.

If I file my appeal on day 180, will it be accepted?

Yes, if you file ON the deadline day (not after). However, this is risky because: (1) If filing online, system issues could cause problems, (2) If mailing, postmark must be by that date (use certified mail), (3) Time zones matter for online submission. Best practice: File at least 2-3 days before deadline to avoid any issues.

Do weekends and holidays count toward the deadline?

Yes. Appeal deadlines are calculated in calendar days, not business days. Weekends and holidays count. However, if your final deadline falls on a weekend or federal holiday, most insurers extend to the next business day. Don't rely on this—file earlier.

What if I filed within the deadline but the insurance company says it's late?

This occasionally happens due to: (1) Discrepancy between postmark date and received date, (2) Online submission timestamp issues, (3) Insurance company error. Immediately respond with proof of timely filing: certified mail receipt showing postmark date, online confirmation email with timestamp, fax confirmation showing transmission date. Request they overturn the late filing rejection and review your appeal on its merits.

Can I appeal a denial if I already started a new claim submission?

Yes. Filing a new claim (corrected claim) does not prevent you from appealing the original denial. In fact, you should do both: (1) Resubmit the claim with corrected information (might get paid faster), and (2) File appeal of the original denial to preserve your appeal rights. If the corrected claim is approved, you can withdraw the appeal.

What's the deadline for external review after my internal appeal is denied?

External review deadlines vary by state, ranging from 4-6 months after your internal appeal is denied. Federal minimum is 4 months. Some states (California, New York, Massachusetts) have specific external review processes with their own timeframes. Your internal appeal denial letter must state your external review rights and deadline.

How long do I have to appeal a prior authorization denial vs. a claim denial?

It's the same deadline. Prior authorization denials (denial before service) and claim denials (denial after service was provided) have the same appeal filing timeframe: 60-180 days depending on your insurer. The urgency is often higher for prior auth denials if the patient needs treatment immediately—in which case, request expedited appeal (72-hour decision).

Can my doctor appeal on my behalf, or do I have to file it myself?

Both you (the patient/member) and your doctor (provider) can file appeals. Most successful appeals involve the doctor because they provide the medical evidence and clinical justification. Some insurance companies have separate provider appeal processes with the same deadlines. Either you or your doctor can file—whoever acts first. Practices often handle appeals on behalf of patients since they have the medical records and documentation needed.

Don't Let Appeal Deadlines Cost You Thousands

Here's the truth: Missing appeal deadlines is the most expensive billing mistake practices make.

Every year, practices lose:

• $25,000-$75,000 in recoverable revenue from missed deadlines
• 120+ hours of staff time on late appeals that get auto-rejected
• 82% chance of overturning legitimate denials

The solution isn't working harder—it's automating deadline tracking.

How Muni Eliminates Missed Deadlines

Automatic Deadline Calculation:

• Scans denial letter for insurance company and denial date
• Calculates exact deadline (accounts for insurer, plan type, state variations)
• Tracks all appeals in one dashboard

Proactive Alert System:

• Email/SMS alerts at 90, 60, 30, 14, and 7 days before deadline
• Priority scoring (urgent, high, medium, low)
• Never miss another deadline due to calendar oversight

One-Click Appeal Filing:

• Generate complete appeal letter in 5 minutes
• Auto-populate insurance company submission addresses/portals
• Track submission confirmation

Results:

• Zero missed deadlines from tracking errors
• File appeals 67% faster (22 days vs. 67 days average)
• 89% overturn rate (vs. 82% industry average)
• $47,000+ annual revenue recovery per practice

→ Start 3 Free Appeals with Deadline Tracking

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This guide is updated for 2025 insurance appeal procedures. Appeal deadlines vary by insurance company, plan type, and state. The information provided represents standard timelines for major insurers, but your specific plan may have different requirements. Always verify your exact deadline by reading your denial notice and confirming with your insurance company. Muni Appeals stays current with all insurance company policy changes and automatically tracks deadlines for Aetna, Blue Cross Blue Shield, UnitedHealthcare, Cigna, Humana, Premera, and all Medicare Advantage plans.