In Ohio, a parent can run into a different state insurance review system quickly. In Michigan, the common advice that "you only have 30 days" is usually wrong for health insurance denials.

For most private health plans, federal ACA rules give you 180 days from the denial notice to file an internal appeal. That is the big deadline people miss, not 30 days. If your child's treatment is urgent, the insurer usually must decide an urgent care appeal within 72 hours. For non-urgent requests, insurers generally have 30 days for pre-service care and 60 days for care already received.

If the insurer upholds the denial, you may still have time for an external review. In many cases, the deadline is 4 months from the final internal denial. In Michigan, the Department of Insurance and Financial Services (DIFS) handles complaints and external review issues for many fully insured plans sold in the state.

Detroit-area parents often get tripped up because not every plan follows the same path:

• Employer self-funded plan: usually governed by ERISA; the U.S. Department of Labor Employee Benefits Security Administration is the key agency, not DIFS.
• Michigan Medicaid or MIChild: appeal rights usually run through Michigan Department of Health and Human Services, with a fair hearing deadline that can be much shorter, often 90 days.
• Marketplace or individual policy: usually ACA appeal rules plus possible DIFS involvement.

Look at the denial letter for three things: the date on the letter, whether it says internal appeal, and whether the plan is self-funded or fully insured. If your child needs care now, use the word urgent when the situation fits; that can force a much faster review timetable.