On occasion, a person may not agree with a particular decision they receive from MNsure. These can be decisions about:
- If a person qualifies to enroll in a program through MNsure
- 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
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.
Attention employers: Employers who receive a shared responsibility notice have the right to appeal the employee's advanced premium tax credit (APTC) eligibility determination with The Department of Health & Human Services Marketplace Appeals Center.
Right to Appeal
It is your right to appeal if you feel that MNsure has made an incorrect decision or action about your application. MNsure will not retaliate against or penalize consumers for filing an appeal.
Before You Appeal
Did you know many issues can be resolved without going through the appeal process?
Consider speaking with a MNsure specialist before filing an appeal for a faster resolution. Specialists can provide options for updating your application, changing your enrollment or reviewing your case. Call our Contact Center at 651-539-2099 (855-366-7873 outside the Twin Cities) for further assistance.
Do you have questions about your enrollment or want to end your private health insurance?
You can review your enrollment information from your enrollment dashboard or cancel or disenroll all members from a plan.
How to Start an Appeal
Do any of the following to start an appeal. Be sure to sign and date the form before you submit it.
- Sign in to your MNsure account to access the Appeal Request Form. Then complete and submit the form online.
- Download a PDF version of the form, save it to your computer and email the completed form to email@example.com. Or print the completed form and mail it to MNsure Legal and Compliance, PO Box 64253, St. Paul, MN 55164-0253.
- Call the MNsure Contact Center at 651-539-2099 (855-366-7873 outside the Twin Cities). A MNsure representative can help you complete and submit the form.
- Come in person to the Minnesota Department of Human Services Information Desk: 444 Lafayette Road N, St. Paul, MN 55155. (This option may be unavailable during the COVID-19 pandemic.)
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 request 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 frequently asked questions (FAQ) about appeals.