On occasion, a person or an employer may not agree with a particular decision they receive from MNsure. These can be decisions about:
- if a person or business qualifies to enroll in a program through MNsure, including for small businesses employees and employers;
- the amount of advance payment of premium tax credits or cost-sharing reductions figured by MNsure;
- eligibility to enroll in and claims related to Medical Assistance and MinnesotaCare through MNsure;
- employer notification that an employee qualifies for advanced premium tax credits.
You can file an appeal to ask for a fair review of your case. MNsure has set up an appeals process to give you that fair review.
Right to Appeal
It is your right to appeal if you feel that MNsure has made an incorrect decision or action about your application or employer notice. MNsure will not retaliate against or penalize consumers for filing an appeal.
How to Start an Appeal
Individuals and employers may use the same appeal request form and process.
- Visit MNsure.org and log into your account to access the Appeal Request Form.
- Click Appeal Request Form (PDF), save the form to your computer, complete and save and then email it to firstname.lastname@example.org or mail it to the address listed below.
- Call the Contact Center 855-366-7873 or 651-539-2099.
- Mail the Appeal Request Form to: MNsure, 81 East 7th Street, Suite 300, St. Paul, MN 55101-2211
- Come in person to the Minnesota Department of Human Services Information Desk: 444 Lafayette Road N, St. Paul, MN 55155
Once you start an appeal, we will send you messages to let you know how it is progressing. You will get notices about where and when your hearing will take place. You may use our online help tool to check the status of your appeal.
Timing is very important:
- You must file your appeal within 90 days of the date of your eligibility determination notice.
- For decisions on Medical Assistance or MinnesotaCare, you must file your appeal within 30 days of the date of your eligibility notice. This goes up to 90 days if you can show good cause for filing late.
- Important: for Medical Assistance or MinnesotaCare, your benefits continue only if you appeal the later of: within 10 days of the date of the eligibility notice; or before the date when the action takes place.
- You decide that you disagree with MNsure's decision.
- You file your appeal.
- MNsure schedules the review, which may be a hearing, and lets you know the details.
- You prepare for your review.
- The appeals examiner conducts the review.
- The appeals examiner makes a decision and sends it to you in writing.
Once you have filed your appeal, it may take up to 90 days for MNsure to conduct the appeal process and issue a decision.
You do not need a lawyer to appeal, but you may have one. You can represent yourself at your appeal. You can also be represented by a relative, friend or other person, but you must be present.
You will get a decision in writing when the appeal is complete.
Complete procedural rules for MNsure appeals can be found at: Minnesota Rules, Parts 7700.0100 - 7700.0105.
Please also see FAQ about appeals.