If your Minnesota Medicaid coverage was denied, cut, or terminated, you have the right to appeal, request a fair hearing, and often keep your benefits while the appeal is decided., Minnesota delivers most Medical Assistance and MinnesotaCare through managed care health plans, so the path usually starts with an appeal to your plan and, if that fails, a state fair hearing before the Department of Human Services.

In This Guide

What you can appeal in Minnesota Medicaid

Federal law guarantees every Medicaid applicant and beneficiary the right to a fair hearing before the state agency. Section 1902(a)(3) of the Social Security Act (42 USC 1396a(a)(3)) requires each state plan to grant a hearing to anyone whose claim for medical assistance is denied or is not acted on with reasonable promptness, and the implementing regulation at 42 CFR 431.220 extends that right to anyone who believes the agency acted erroneously or made an adverse determination.

In Minnesota, Medical Assistance (MA, the state's Medicaid program) and MinnesotaCare appeals cover the full range of actions that affect your coverage. If a service has been denied, reduced, or terminated, you can file an appeal and request a state fair hearing. That includes:

  • A denial of your application for MA or MinnesotaCare
  • A termination or reduction of eligibility or a covered service, including a cut to the hours of personal care you receive
  • A denial or limited authorization of a service, such as a prior authorization denial
  • A renewal or recertification denial
  • A health plan's denial, reduction, suspension, or termination of a service

The right reaches across the program, and it applies whether the action came from the state agency or from the managed care health plan that administers your benefits.

The Minnesota Medicaid appeal deadlines that decide your case

In Minnesota's managed care system, several appeal windows run at once, and each is measured from a different event. The shortest is the 10-day window to keep your benefits during the appeal. The table below lays them out.

Deadline When it runs What it does
Health plan appeal: 60 days From the date on the health plan's notice about the action The required first step; you must file it before a state appeal
Keep benefits (plan appeal): 10 days From the date on the health plan's notice Continues the disputed service while the plan decides
State fair hearing: 120 days From the date of the health plan's appeal decision The deadline to request a state appeal in writing
Keep benefits (state appeal): 10 days From the date of the health plan's appeal decision Continues the service while the state appeal is decided

Two points about these numbers. First, federal law sets an outer ceiling: a state must allow a reasonable time, not to exceed 90 days from the date a notice of action is mailed, to request a hearing. Minnesota's managed care windows above run from the plan's notice or decision rather than from that single mailing date, so read the deadline off your own notice and do not assume you have longer.

Second, the deadlines for keeping your benefits are far shorter than the deadlines for filing the appeal itself. You have 60 days to file a health plan appeal, but only 10 days to file it in a way that keeps the disputed service flowing. Missing the 10-day window does not end your right to appeal; it ends your ability to keep the service while you do.

How to keep your benefits during the appeal

Keeping your benefits during an appeal is called aid paid pending. It is not automatic, and the window to secure it is short: 10 days from the date on the notice.

The federal rule sits behind it. Under 42 CFR 431.230(a), if the agency sent the required advance notice and you request the hearing before the action takes effect, the agency may not terminate or reduce your services until a decision is rendered after the hearing. A request made after the action's effective date does not trigger continuation.

Minnesota operationalizes that federal rule with two 10-day windows. To keep getting the disputed service while your health plan considers your appeal, file the plan appeal within 10 days of the date on the plan's notice. To keep the service flowing while your state appeal is considered, file the state appeal within 10 days of the date of the plan's appeal decision.

One caution before you rely on it. If your benefits continue during the appeal and the plan's or agency's action is later upheld, the agency may recover the cost of the services that were furnished solely because your benefits continued. That is the tradeoff: continuing benefits protects your care during the fight, but a loss can carry a repayment. When any adverse-action notice arrives, find the date on it, file inside the 10-day window, and put your request to continue benefits in writing.

Managed care appeals: exhaust your health plan first

Minnesota delivers most Medical Assistance and MinnesotaCare through managed care organizations (MCOs), the health plans that administer your benefits. When a health plan denies or cuts a service, you appeal to the plan first, and you must complete that internal appeal before you can request a state fair hearing. These rules come from the federal managed care regulations at 42 CFR Part 438.

The participating MA and MinnesotaCare health plans are Blue Plus, HealthPartners, Hennepin Health, Itasca Medical Care, Medica, PrimeWest Health, South Country, and UCare. Your notice will name the plan that acted and tell you how to appeal to it.

What the plan's notice must tell you

Under 42 CFR 438.404, a managed care plan must give you timely, written notice of an adverse benefit determination, which includes a service denial, a limited authorization, a reduction or termination of a previously authorized service, or a denial of payment. That notice must explain the reasons for the action, how to file the plan's one internal appeal, how to request an expedited appeal, and how to reach a state fair hearing afterward.

The internal appeal and how fast the plan decides

You have 60 days from the date on the plan's notice to file the internal appeal., The plan issues a written decision within 30 days of the date you file the internal appeal, or within 72 hours for an approved expedited (fast) appeal. Under the federal rule, either timeframe can be extended by up to 14 calendar days if you request the extension or the plan shows the state that more information is needed and the delay is in your interest. Ask for the expedited track whenever waiting on the standard timeline could seriously jeopardize your health or ability to regain function.

Then the state fair hearing

After the health plan issues its appeal decision, you request a state appeal in writing within 120 days of that decision. Federal law backs this up: once a plan upholds its determination, the state must give you no less than 90 and no more than 120 calendar days from the plan's notice of resolution to request a state fair hearing, and Minnesota sets that window at 120 days. Skipping the plan appeal and going straight to a state hearing will get the hearing request dismissed.

How to request a fair hearing in Minnesota

The Minnesota Department of Human Services (DHS) decides state appeals through its Appeals Division, where human services judges conduct the fair hearing. The Appeals Division conducts administrative fair hearings for the department's health care programs, including MA and MinnesotaCare.

To request a state fair hearing, complete the Appeal to State Agency form (DHS-0033). You can submit it three ways: online, by mail, or by fax. You can also make a health plan appeal verbally by calling the Appeals Division at 651-431-3600. Whichever method you use, request the hearing in writing within the 120-day window and, if you want your benefits to continue, file within the 10-day window and state clearly that you want aid paid pending.

At the hearing, a human services judge takes evidence, reviews the record, and issues a decision. Bring the plan's or agency's notice, any letters from your treating provider documenting medical need, and any records that show you met the program's rules. For a service reduction or a level-of-care dispute, a letter from your physician documenting the need is often what decides the case.

Frequently Asked Questions

How long do I have to appeal a Minnesota Medicaid denial?

It depends on who acted. If a managed care health plan denied, reduced, or terminated a service, you have 60 days from the date on the plan's notice to file the plan's internal appeal, then 120 days from the plan's appeal decision to request a state fair hearing. Federal law sets an outer ceiling of 90 days from the date a notice of action is mailed for requesting a hearing, so read the exact deadline off your own notice rather than assuming.

Can I keep my Medicaid benefits while I appeal?

Yes, if you act fast and ask for it. Under federal law, if you request the hearing before the action takes effect, your services continue until a decision is rendered. In Minnesota, that means filing the health plan appeal within 10 days of the plan's notice, and filing the state appeal within 10 days of the plan's appeal decision. Keeping benefits is never automatic, so you must specifically request it. If you lose, the agency may recover the cost of the services that continued only because you appealed.

Do I need a lawyer for a Minnesota Medicaid fair hearing?

No. You can represent yourself, bring a family member, or ask a friend to help. That said, representation can make a real difference for level-of-care disputes, prior authorization denials, and complex service reductions, where documentation from your treating provider often decides the outcome. Free or low-cost help is available from Minnesota legal aid organizations; the DHS Appeals Division at 651-431-3600 can also point you to the right process.

What is the difference between a health plan appeal and a state fair hearing?

A health plan appeal is the internal appeal you file with your managed care plan, such as Blue Plus, Medica, or UCare, and it is the required first step. Only after the plan issues its decision can you request a state fair hearing, which a human services judge at the DHS Appeals Division conducts.

What happens if I miss the deadline?

If you miss the 10-day window for keeping your benefits, you can still appeal within the longer filing windows, but the disputed service may stop while your appeal is decided. If your coverage was terminated only because you did not return a renewal form or requested information on time, federal law requires the agency to reconsider your eligibility without a new application if you submit what was missing within 90 days of the termination date.

Learn More

MedicaidHow to Appeal a Medicaid DenialDenied Medicaid? You can appeal, and one deadline decides whether your benefits keep flowing during the appeal. Know your fair-hearing rights and act fast. MedicaidMinnesota Medicaid: A Guide for Seniors and FamiliesMinnesota Medical Assistance covers long-term care for seniors: the 2026 $3,000 asset limit, spend-down rules, $132 personal needs allowance, and how to apply. MedicaidHow to Apply for Minnesota Medicaid (Medical Assistance)How to apply for Minnesota Medicaid (Medical Assistance) in 2026: ApplyMN, county and tribal offices, the medically needy spend-down, documents, and appeals. MedicaidYour Guide to Minnesota Medicaid Income and Asset LimitsSee the 2026 Minnesota Medicaid income limits: 138% FPG with no asset test under 65, the 100% FPG and $3,000 asset rules at 65, and the spend-down.

Find personalized help navigating a Minnesota Medicaid appeal at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

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