Appeals and Fair Hearings

If you do not agree with a decision that the Department has made you can ask for an internal appeal

An internal appeal asks us to look again at a decision we made. You can tell someone who did not make the decision why you think it is wrong. You must ask for an internal appeal within 60 calendar days of the department’s decision.

If it would hurt you to wait for an internal appeal, ask for a fast appeal. A fast appeal is also called "expedited". We decide most fast appeals in 72 hours.

Call our Customer Support Center at 1-800-250-8427 to ask for an internal appeal.

If the decision you received is to reduce or end benefits or services you are currently getting and you want your benefits or services to continue during your internal appeal, you must ask us at the time you ask for your internal appeal. If you get benefits or services during your internal appeal, you may be asked to pay for them if you do not win your internal appeal.

Do you need help with your internal appeal? We can help you with:

  • Filling out papers
  • Helping you take part in the appeal
  • Getting an interpreter
  • Answering questions
  • Helping you understand what is happening

You can also get free help from Vermont Legal Aid. Call their Office of Health Care Advocate at 1-800-917-7787. OR go to their website at https://vtlawhelp.org/ on the internet.

If you lose the internal appeal, you can ask for a Fair Hearing. In a Fair Hearing the Human Services Board will hear your case. BUT you must finish your internal appeal first. This is called exhaustion. What if we miss the deadline to decide your internal appeal? Then you do not have to keep waiting. You can go ahead and ask for a Fair Hearing.

If you are told that your benefit is changed because of a change in federal or state law, an internal appeal will not be granted, but you may ask for a fair hearing.

Do not agree with the internal appeal decision? Or did you only win part of the internal appeal? You can ask for a Fair Hearing

Your internal appeal must be over before you can ask for a Fair Hearing.

You have 120 days to ask for a Fair Hearing. The 120 days start with the date on the letter telling you the internal appeal decision. There are 4 ways to ask for a Fair Hearing:

  1. Call our Customer Support Center at 1-800-250-8427. OR call the Human Services Board at 802-828-2536. OR
  2. Email us at AHS.COHSBContact@vermont.gov OR
  3. Send a letter to:

Human Services Board

14-16 Baldwin Street, 2nd floor

Montpelier, VT 05633-4301 

OR

  1. Do it in person.

Important! Did you get an expedited (fast) internal appeal?

Then you can ask for an expedited (fast) Fair Hearing IF:

  • You lost the internal appeal or lost part of the internal appeal OR
  • Your fast-internal appeal was not decided before the deadline

What if I have questions or need help?

Please call the Vermont Health Connect, Green Mountain Care Customer Support Center at 1-800-250-8427 (TDD/TTY) 1-888-834-7898 for more information or to file an internal appeal or fair hearing.

Contact Information

Green Mountain Care
Health Access Member Services
Department of Vermont Health Access
280 State Dr.
Waterbury, VT 05671-1010
Phone: 1-800-250-8427
Relay services for the Deaf and hard of hearing: 711