Health insurance external review by state
After a final internal denial, most health plans must let you ask an independent reviewer to look at the decision. This is called external review. Who runs it depends on your state and your plan. This table shows each state's process type and, for 26 states, the official external review page we found on a government site.
How to use this table
- Your final denial notice is the best guide. It must say how to ask for external review and who handles it.
- Self-funded employer plans (common at large employers) usually use the federal process, whatever your state. See ERISA vs state-regulated plans.
- In Alabama, Florida, Georgia, Texas and Wisconsin, the federal process applies to state-regulated plans too, per KFF.
- Deadlines and steps: see the external review guide and the deadline calculator.
| State | External review process | Official page |
|---|---|---|
| Alabama | Federal process | Not yet located; see your denial notice |
| Alaska | State process | Not yet located; see your denial notice |
| Arizona | State process | Not yet located; see your denial notice |
| Arkansas | State process | Official page |
| California | State process | Official page |
| Colorado | State process | Not yet located; see your denial notice |
| Connecticut | State process | Official page |
| Delaware | State process | Official page |
| District of Columbia | State process | Not yet located; see your denial notice |
| Florida | Federal process | Not yet located; see your denial notice |
| Georgia | Federal process | Not yet located; see your denial notice |
| Hawaii | State process | Official page |
| Idaho | State process | Official page |
| Illinois | State process | Official page |
| Indiana | State process | Not yet located; see your denial notice |
| Iowa | State process | Official page |
| Kansas | State process | Not yet located; see your denial notice |
| Kentucky | State process | Official page |
| Louisiana | State process | Not yet located; see your denial notice |
| Maine | State process | Not yet located; see your denial notice |
| Maryland | State process | Official page |
| Massachusetts | State process | Not yet located; see your denial notice |
| Michigan | State process | Not yet located; see your denial notice |
| Minnesota | State process | Not yet located; see your denial notice |
| Mississippi | State process | Official page |
| Missouri | State process | Not yet located; see your denial notice |
| Montana | State process | Not yet located; see your denial notice |
| Nebraska | State process | Official page |
| Nevada | State process | Not yet located; see your denial notice |
| New Hampshire | State process | Not yet located; see your denial notice |
| New Jersey | State process | Official page |
| New Mexico | State process | Official page |
| New York | State process | Official page |
| North Carolina | State process | Official page |
| North Dakota | State process | Official page |
| Ohio | State process | Not yet located; see your denial notice |
| Oklahoma | State process | Official page |
| Oregon | State process | Official page |
| Pennsylvania | State process | Not yet located; see your denial notice |
| Rhode Island | State process | Not yet located; see your denial notice |
| South Carolina | State process | Official page |
| South Dakota | State process | Official page |
| Tennessee | State process | Not yet located; see your denial notice |
| Texas | Federal process | Not yet located; see your denial notice |
| Utah | State process | Official page |
| Vermont | State process | Official page |
| Virginia | State process | Not yet located; see your denial notice |
| Washington | State process | Official page |
| West Virginia | State process | Official page |
| Wisconsin | Federal process | Not yet located; see your denial notice |
| Wyoming | State process | Official page |
Sources and checks
Process type: KFF: State External Appeals Review Processes and HealthCare.gov: External review. Official pages were found on state government sites. Each link was checked on 2026-10-18 or 2026-10-20 with one polite automated request; pages added on 2026-10-20 were also checked for external review wording. We do not copy state-specific deadlines from these pages; open the page or your notice for those. If a link is stale, email [email protected] (see corrections).