Buckeye Community denied your claim in Ohio. Here is your deadline.
Put in the date on your Buckeye Community Health Plan notice and get both federal deadlines as calendar dates.
Free, for a Buckeye Community Health Plan denial in Ohio, and it runs entirely in your browser. The date, the plan type and the state you pick are never sent to us and never stored.
Buckeye Community Health Plan denied 603,488 of 5,038,090 in-network claims in Ohio; every one of those denials had these same two dates on it. Across Ohio as a whole the insurers in this file denied 12.7% of in-network claims, 1,509,307 of them, and 20,482 were appealed.
Or let the $29 Appeal Kit date each step and write the claim-file and external-review requests.
Buckeye Community Health Plan denied 12% of in-network claims in Ohio, 603,488 claims out of 5,038,090.
Further down this page, after the free steps: the paid next step.
Insurance got denied, what to do next?
Those 603,488 denials are 40% of every in-network denial recorded in Ohio in this release, which makes Buckeye Community Health Plan the 1st largest source of denials of the 7 insurers reporting there. Spread across its 19 plans in the state that is about 31,763 denials per plan. 521 internal appeals were filed against those 603,488 denials. Every one of those denials carried the same two dates the tool at the top of this page works out.
Two dates matter more than anything else on this page, and they run the same in Ohio as everywhere else. You have 180 days from the date on your denial notice to file the internal appeal, and then 4 months from the final internal denial to ask for an independent external review. If waiting would seriously jeopardize your health you can ask for both to be expedited, decided in about 72 hours. Both timeframes are federal, not your insurer's choice, 29 CFR 2560.503-1 (PDF) and 45 CFR 147.136 (PDF), in plain English at HealthCare.gov, and your own denial letter states the ones that govern your plan. The PDFs are the same sections on govinfo.gov, which serves them without a challenge page, so an automated reader can check these two dates as easily as you can.
You are not alone, and here is the measured version of that sentence: 603,488 in-network claims were denied by Buckeye Community Health Plan in Ohio in a single plan year. A denial rate is a fact about an insurer's book of business. It is not a judgment about you, and it is not the last word on your claim.
- Of the 7 insurers reporting a denial rate in Ohio, Buckeye Community Health Plan is the sixth highest at 12%. The highest in the state is 24.5% and the lowest is 7.9%.
- That is 3.7 percentage points below the 15.7% national average across this dataset, and 0.7 points below the Ohio average of 12.7%.
- Behind the percentage: 5,038,090 in-network claims were processed under 19 plans in Ohio, and 603,488 of them came back denied.
- For every 10,000 claims Buckeye Community Health Plan denied, about 9 came back as an internal appeal. The other 9,991 stopped at the letter.
- Of the internal appeals it did receive, Buckeye Community Health Plan overturned 54.89%, 286 claims that started life as a no.
- 11 of those denials went on to independent external review, the stage whose decision the plan is required by law to accept. Nationally 22.2% (1,092 of 4,918; interval 22.2-23.8% for counts CMS withheld; 32.6% without SelectHealth) of external reviews are overturned.
- Its most-recorded denial reason is service excluded from the plan at 18.2% of its categorized denials, against 13.4% nationally, a heavier share than the country as a whole. That is the denial mix, not an outcome rate.
- Buckeye Community Health Plan accounts for 40% of every in-network claim denied in Ohio in this file.
- By raw volume it is the 32th largest source of denials among the 135 insurer-state records in the file that report one.
- Put another way: one independent external review was filed for every 54,863 claims Buckeye Community Health Plan denied in Ohio.
- After that, its second-most-recorded reason is administrative reason, 187,006 claims, 18.2% of its categorized denials.
- Third on its own list is referral required, 182,212 claims, 17.7% of what Buckeye Community Health Plan categorized in Ohio. Between them the top three account for 54.2% of its categorized denials.
- Where Buckeye Community Health Plan differs most from the national mix is not medically necessary: 15.6% of its categorized denials in Ohio against 5.5% across the file.
- Read the other way round: 4,434,602 of those 5,038,090 in-network claims were paid, 88% of everything Buckeye Community Health Plan processed in Ohio.
- Spread across the 19 plans it reports in Ohio, that is about 31,763 denied claims per plan, on about 265,163 claims processed per plan.
- Its reason columns add up to 1,027,115 categorized rows against 603,488 denials, 170.2% of them, and every reason share on this page is a share of that first figure rather than of the second.
- Its smallest recorded category in Ohio is member not covered, 42,225 claims, 4.1% of what Buckeye Community Health Plan categorized there.
- Against the file as a whole, this one record is 0.7% of the 83,907,852 in-network claim denials reported by every issuer in it.
- Find the reason code on your denial letter. The reason Buckeye Community Health Plan records most often in Ohio is service excluded from the plan, but yours may be one of the other 8, copy the exact wording and code off your own letter tonight, because that sentence is what your appeal has to answer.
- Ask Buckeye Community Health Plan in Ohio for the clinical criteria they judged you against. Under 29 CFR 2560.503-1 they have to hand you the claim file and the policy they applied, free, on request, and you cannot argue with a checklist you have never read.
- Put both deadlines on your calendar before you go to bed. 180 days from the date on the letter for the internal appeal, 4 months from the final internal denial for external review. The free calculator on this page turns your date into the two calendar dates in about ten seconds. Buckeye Community Health Plan overturned 54.89% of the internal appeals it did receive, 286 claims, so the stage you are about to start is not decorative.
None of those three steps costs anything. Anyone charging you to do them is selling you something you can do yourself in twenty minutes.
How that compares
| Denial rate | Rate | Difference |
|---|---|---|
| Buckeye Community Health Plan | 12% | , |
| Ohio average | 12.7% | -0.7 pts |
| National average (this dataset) | 15.7% | -3.7 pts |
Buckeye Community Health Plan sits at or below the national average across this dataset. A denial rate is a property of the insurer's book of business, coding practice, plan design, the population it covers, not evidence about the merits of any one claim, including yours.
What happened to appeals
| Stage | Filed | Overturned |
|---|---|---|
| Internal appeal (to Buckeye Community Health Plan) | 521 | 54.89% |
| External review (independent) | 11 | not reported |
The gap nobody escalated
603,488 claims denied. 521 internal appeals filed. 11 reached independent external review. Nationally 22.2% (1,092 of 4,918; interval 22.2-23.8% for counts CMS withheld; 32.6% without SelectHealth) of external reviews are overturned and the decision binds the plan.
That is arithmetic from the reported figures, not a prediction: nobody can say what those specific denials would have done at review, because they never got there. What the numbers do establish is that the binding stage was almost entirely unused here.
What that record means for your own Buckeye Community Health Plan letter, and by when. Buckeye Community Health Plan overturned 54.89% of the 521 internal appeals its Ohio members filed against 603,488 denials, and 11 of those Ohio denials went on to the independent stage whose decision binds the plan, Buckeye Community Health Plan's own rows in the plan-year 2027 release of the CMS Transparency in Coverage file, read November 4, 2026 (data.healthcare.gov). Whichever way that lands, nobody files the appeal for you, and the filing runs on a clock set by which plan you hold: an employer or Marketplace plan gives you at least 180 days from the denial notice to file the internal appeal (29 CFR 2560.503-1(h)(3)(i), carried onto individual-market coverage by 45 CFR 147.136(b)(3)(i)), while Medicare Advantage gives you 65 calendar days from the date of its notice (CMS, 42 CFR 422.582(b)) and Medicaid managed care 60 calendar days from the date on the notice (42 CFR 438.402(c)(2)(ii)), both stages free, and the three steps above are the whole of what to do tonight, so take the date printed on your Buckeye Community Health Plan notice and file well inside whichever of those windows is yours. The free steps are above; the $29 kit is the same clock with the letters pre-filled for Buckeye Community Health Plan in Ohio. One payment. No subscription. No cut of your claim.
Buckeye Community Health Plan inside Ohio
Your denial did not happen in a national average. It happened in a state market, alongside 8 other insurers reporting into the same federal file, and these are that market's own figures.
- Across the whole of Ohio, the 9 insurers reporting in this file processed 11,919,238 in-network claims and denied 1,509,307 of them, a state denial rate of 12.7%. Buckeye Community Health Plan is one of those 9.
- That puts Ohio 23th of 29 states by denial rate, 3 points below the 15.7% national average, before you get to what Buckeye Community Health Plan did inside it.
- Ohio recorded 20,482 internal appeals against those denials: one appeal for every 74 claims the state's insurers refused. Buckeye Community Health Plan's own ratio is one for every 1,158.
- Independent external review was reached 114 times in the whole of Ohio, once for every 13,240 denials, against one in 17,061 nationally. 11 of those Ohio filings came from Buckeye Community Health Plan's denials.
- Of the Ohio external reviews that were filed, 31 were overturned, 27.2%. That percentage is measured on 114 reviews, which is why the count beside it matters more than the rate does when you are deciding whether to file against Buckeye Community Health Plan.
- The reason Ohio's insurers record most often is administrative reason, 423,239 claims, 20.1% of the state's categorized denials. Buckeye Community Health Plan records service excluded from the plan most often instead, which is the argument your letter will need to answer.
- The other insurers an Ohio reader could have bought from run from 24.5% (Summa Insurance Company, Inc.) to 7.9% (Community Insurance Company). Buckeye Community Health Plan at 12% sits between the two.
- Put the two together and Buckeye Community Health Plan is responsible for 40% of every in-network claim denied in Ohio in this release, from 42.3% of the claims the state's insurers processed.
- Every Ohio figure in this section is that state's own row in the same federal file Buckeye Community Health Plan's numbers above come from, CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain, and the full Ohio page is free at /states/ohio.
What Buckeye Community Health Plan denies most
The most common denial reason recorded for Buckeye Community Health Plan plans in Ohio is service excluded from the plan. How that denial is beaten →
| Denial reason | Claims | Share | National share |
|---|---|---|---|
| Service excluded from the plan | 187,113 | 18.2% | 13.4% |
| Administrative reason | 187,006 | 18.2% | 17.2% |
| Referral required | 182,212 | 17.7% | 9.6% |
| Not medically necessary | 160,000 | 15.6% | 5.5% |
| Other reasons | 122,497 | 11.9% | 32.4% |
| Provider out of network | 73,249 | 7.1% | 9% |
| Benefit limit reached | 72,813 | 7.1% | 4.9% |
| Member not covered | 42,225 | 4.1% | 7.9% |
The last column is each reason's share of all categorized denials nationally, so you can see where Buckeye Community Health Plan's mix in Ohio differs from everyone else's. This is denial mix, not overturn rate by reason, the federal file does not report appeal outcomes broken down by denial reason, and we do not imply otherwise.
Put the date from your notice in and get the two calendar dates, with the days remaining.
Runs entirely in your browser, the date you type is never sent to us and never stored. Open the full calculator →
Or let the $29 Appeal Kit date each step and write the claim-file and external-review requests.
The three steps at the top of this page are the whole of what you have to do tonight. The longer version, what the internal appeal has to contain, how the independent stage works, and how to ask for expedited handling when waiting would seriously jeopardize your health, is published free here. For what it is worth on this page specifically: Buckeye Community Health Plan overturned 54.89% of the internal appeals it received.
Questions
Is Buckeye Community Health Plan's denial rate in Ohio high?
12% against a national average of 15.7% across the plans in this dataset. It is at or below average. A denial rate describes the insurer, not the merits of your claim.
How many people appealed a Buckeye Community Health Plan denial in Ohio, and how many won?
521 internal appeals were filed against 603,488 denials, and 54.89% of them were overturned (286 claims). 11 went on to independent external review.
How does Buckeye Community Health Plan compare with other insurers in Ohio?
Of the 7 insurers in Ohio with a reported denial rate, Buckeye Community Health Plan ranks 6 highest at 12%. The highest in Ohio is Summa Insurance Company, Inc. at 24.5%; the lowest is Community Insurance Company at 7.9%.
What does Buckeye Community Health Plan deny most often in Ohio?
Service excluded from the plan, 187,113 claims, 18.2% of this issuer's categorized denials, against 13.4% nationally. This is the denial-reason mix; the federal file does not report overturn rates by reason.
How long do I have to appeal a Buckeye Community Health Plan denial in Ohio?
Generally 180 days from the date on the denial notice to file the internal appeal, then generally four months from the final internal denial to request independent external review. Expedited review, decided in about 72 hours, is available where delay would seriously jeopardize your health. Those timeframes are federal, so they are identical for every insurer reporting in Ohio, Buckeye Community Health Plan included, what varies by state is who runs the independent review at the end. Your own denial letter states the deadlines that govern your plan; that letter is the authority.
Does appealing a Buckeye Community Health Plan denial in Ohio cost anything?
The internal appeal to Buckeye Community Health Plan is free. External review is free under the HHS-administered federal process; where an issuer uses a contracted independent review organization or a state process, any fee is capped at $25 per review. Nobody in Ohio can be charged more than that to file one.
Can Buckeye Community Health Plan ignore an external review decision in Ohio?
No, and that is the whole point of the stage. External review decisions are binding on the plan by law, which is what makes the 11 external reviews recorded against 603,488 Buckeye Community Health Plan denials in Ohio the striking number on this page.
Buckeye Community Health Plan sits at 12% in Ohio against 15.7% nationally, and that is the whole of what this page can honestly tell you about your own claim. We are not going to tell you that you will win. This page prints the insurer's own reported numbers whichever way they fall. If what it says does not match the letter in your hand, write to us and we will correct the page.
Axion Labs · hello@getaxionlabs.comEverything you need for your Buckeye Community Health Plan appeal in Ohio: your two deadlines, the argument that fits your denial reason, the letters, a brief for your doctor on what the reviewer checks, and the external review request. One payment. No subscription. No cut of your claim. Opens on screen the moment you pay. 14-day refund, no questions, one email to hello@getaxionlabs.com.
The Buckeye Community Health Plan figures on this page, the 12% denial rate, the 603,488 denials and the 11 external reviews, are this issuer’s own reported rows in that file.
Counts: CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain. Rights and timeframes: 29 CFR 2560.503-1 (180 days, and your free right to the claim file) and 45 CFR 147.136 (4 months, and what qualifies), explained at HealthCare.gov. Expedited review is decided in about 72 hours under both sections.
Reading either regulation from a script rather than a browser: eCFR answers automated fetches with a challenge page, so the same two sections are mirrored as government PDFs at govinfo.gov (29 CFR 2560.503-1) and govinfo.gov (45 CFR 147.136).