Your drug plan didn't answer by its own deadline

This is one of the most common places a family gets stuck — not because the request was denied, but because nobody told them what happens when the plan simply stops responding. Under the rule, silence past the deadline isn't a dead end; it's treated exactly like a denial, and the case is required to move to the Independent Review Entity without you having to file anything new.

It's worth calling to confirm the forward actually happened rather than assuming it did. Plans are required to do it automatically within 24 hours of missing their own deadline, but a phone call that gets you a real case number at C2C is worth more than waiting and hoping.

Here's what actually moves this forward:

The plan or C2C should confirm a case number for the forwarded appeal.

National contacts for this situation:

Whatever brought you to this page is a situation the appeal process already accounts for — it's not a sign the case is broken or that you're starting over. The same level structure, the same rule-based reasoning, and the same deadlines already in motion for your case keep applying.

If you want the full picture of how the appeal levels fit together and where a case like this sits in that sequence, that's covered on its own page.

Families deal with this kind of detour more often than the standard version of the process suggests — the straightforward path from denial to letter to decision is common, but it's far from the only real path a case takes.

Whatever the situation, the next real step is usually a phone call — to the contact listed above, or to your state's free counseling program — not another form to fill out on your own.