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Get Health Insurance Marketplace Appeal Request Form

Rhode Island South Carolina South Dakota Utah Vermont Virginia Washington To get an Appeal Request Form for Marketplace appeals in other states, go to HealthCare.gov/can-I-appeal-a-marketplace-decision To file an appeal, fill out this form and mail it here: Health Insurance Marketplace 465 Industrial Blvd. London, KY 40750-0061 You can also file an appeal by calling the Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855-889-4325. Requesting an appeal is time sensitive. Pl.

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