What are appeals and fair hearings?
An appeal is a complaint you make when you feel an action was wrong. When you appeal an action, you are asking for a fair hearing about it.
A fair hearing is a meeting with a fair hearing officer and someone from the Department and you. You can talk about your complaint during the fair hearing, and the fair hearing officer will decide what to do.
You can appeal if the Department:
Denies your application
Stops your benefits (coverage)
Says that you will start to get fewer benefits
Changes your premiums or co-payments
You can also appeal if you think we made a mistake about any decision. You must make your appeal within 60 days of when the action happened.
You may not get a fair hearing if the action happened because of a change in the law.
If you are in a managed care health plan, you can appeal any decision that the plan makes if you think it is wrong. Check your plans member handbook to find out how to make an appeal or call your plan for more information. The number is on your managed care health plan card.
How to make an appeal
You can write a letter asking for a fair hearing or fill out a Notice of Appeal form. (You can get one from the All Kids office.) You can also call to make an appeal.
If you write a letter or fill out the form, you should do one of the following:
Bureau of Administrative Hearings
401 South Clinton, 6th Floor
Chicago, IL 60607
or fax it to: 1-312-793-0095
All Kids Unit
P.O. Box 19122
Springfield, IL 62794
If you want to make an appeal over the telephone, call 1-800-435-0774 (TTY: 1-877-734-7429). The call is free.
All Kids Hotline 1-866-ALL-KIDS (1-866-255-5437)