By state / Michigan
Michigan
- Regulator
- Michigan Department of Insurance and Financial Services (DIFS)
- External review
- State-run. Request it through the regulator after the plan's final internal denial; the federal floor is 4 months (45 CFR 147.136).
- Published reversal rate
- Not published by the regulator · source
- Notes
- Data gap on count fields: DIFS publishes PRIRA (Patient's Right to Independent Review Act) decisions individually on its site but does not publish consolidated overturn statistics in a discoverable form. 2024 DIFS Annual Report identified.
Before external review
File the plan's internal appeal first (at least 180 days for ACA-compliant plans; the letter states the date). Ask for the claim file and the criteria the plan applied; both are free on request. Self-funded employer plans use the federal external review and the U.S. Department of Labor, not the state.
More on Michigan: state appeal rights · External Review Index entry · insurer denial rates (HealthCare.gov states).
Verified 2026-09-15. The regulator's site and your denial notice control.