File an Appeal

Medium

Applicants or recipients of Medicaid who are dissatisfied with a decision made by the county agency or the North Dakota Department of Human Services, or who have not had their application acted on with reasonable promptness, may appeal to the North Dakota Department of Human Services.

Nondiscrimination Policy and Related Information

Client Rights and Appeals

Medium

To File an Appeal:

An appeal can be filed verbally over the phone, or in written format by email, fax or mail.
A request to appeal must be filed no later than 30 days from the date the notice of action is mailed.
You can use SFN 162: Request for Hearing to file the appeal but it is not required.
You are not required to sign SFN 162: Request for Hearing to submit the appeal request.
If you do not use SFN 162: Request for Hearing, please provide your name, contact information, and program decision or error that you are appealing.