Denial Facts
Ohio

Buckeye Community denied your claim in Ohio. Here is your deadline.

Your two dates, free

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 714,834 of 3,673,782 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 17.9% of in-network claims, 2,934,307 of them, and 35,236 were appealed.

Buckeye Community Health Plan denied 19.5% of in-network claims in Ohio, 714,834 claims out of 3,673,782.

Insurance got denied, what to do next?
We hear this most. r/HealthInsurance, thread title, read September 3, 2026.
The number nobody else publishes, and here it is missing. CMS publishes no external-review figure for Buckeye Community Health Plan in Ohio, so nobody, including the regulator, can say whether anyone ever got that far. We print no number rather than reading an absence as a zero. Nationally, 5,881 of 84,502,749 denials reached that stage, one in every 14,369, and 32.8% of those were overturned.

Those 714,834 denials are 24.4% 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 10 insurers reporting there. Spread across its 17 plans in the state that is about 42,049 denials per plan. 333 internal appeals were filed against those 714,834 denials. Every one of those denials carried the same two dates the tool at the top of this page works out.

The clock your letter has to describe, in actual dates

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.

Data verified September 5, 2026 · CMS Transparency in Coverage Public Use File (PY2026 release, PY2024 claims), data.healthcare.gov — US Government public domain

You are not alone, and here is the measured version of that sentence: 714,834 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.

What to do tonight
  1. Find the reason code on your denial letter. The reason Buckeye Community Health Plan records most often in Ohio is administrative reason, 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.
  2. 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.
  3. 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 59.46% of the internal appeals it did receive, 198 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.

19.5%
In-network denial rate
714,834
Claims denied
17
Plans in Ohio
333
Internal appeals filed
59.46%
Internal overturn rate

How that compares

Denial rateRateDifference
Buckeye Community Health Plan19.5%,
Ohio average17.9%+1.6 pts
National average (this dataset)18.7%+0.8 pts

Buckeye Community Health Plan denies 0.8 percentage points more of its in-network claims than 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

StageFiledOverturned
Internal appeal (to Buckeye Community Health Plan)33359.46%
External review (independent)not reportednot reported
Read the table for what it is: the external-review row above shows a dash, which means not reported and not zero, the Ohio absence this page states once at the top for Buckeye Community Health Plan and sources once at the foot. External review is free to you and the insurer must follow the decision, whatever this file does or does not record about it.

What that record means for your own Buckeye Community Health Plan letter, and by when. Buckeye Community Health Plan overturned 59.46% of the 333 internal appeals its Ohio members filed against 714,834 denials, and the Ohio escalation count for Buckeye Community Health Plan is the figure this page names as absent at the top, so how many of those denials went on to the independent stage is not something this page can tell you, Buckeye Community Health Plan's own rows in the plan-year 2026 release of the CMS Transparency in Coverage file, read September 5, 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 60 calendar days after you receive its notice (42 CFR 422.582(b)) and Medicaid managed care the same 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 10 other insurers reporting into the same federal file, and these are that market's own figures.

What Buckeye Community Health Plan denies most

The most common denial reason recorded for Buckeye Community Health Plan plans in Ohio is administrative reason. How that denial is beaten →

Denial reasonClaimsShareNational share
Administrative reason162,47923.9%22.5%
Referral required109,16216%8.4%
Service excluded from the plan106,93115.7%11.6%
Not medically necessary79,84411.7%4.6%
Member not covered66,1049.7%6.6%
Other reasons62,7009.2%32.3%
Provider out of network53,1677.8%9.8%
Benefit limit reached40,5546%4.2%

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.

Work out your two deadlines

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 →

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 59.46% of the internal appeals it received.

Questions

Is Buckeye Community Health Plan's denial rate in Ohio high?

19.5% against a national average of 18.7% across the plans in this dataset. It is above 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?

333 internal appeals were filed against 714,834 denials, and 59.46% of them were overturned (198 claims). How many went on to independent external review is not on the record for Buckeye Community Health Plan in Ohio, that is the absence stated at the top of this page and sourced at the foot of it.

How does Buckeye Community Health Plan compare with other insurers in Ohio?

Of the 10 insurers in Ohio with a reported denial rate, Buckeye Community Health Plan ranks 7 highest at 19.5%. The highest in Ohio is Oscar Buckeye State Insurance Corp. at 26.5%; the lowest is Community Insurance Company(Anthem BCBS) at 8.3%.

What does Buckeye Community Health Plan deny most often in Ohio?

Administrative reason, 162,479 claims, 23.9% of this issuer's categorized denials, against 22.5% 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. The count is the one this page names as absent for Buckeye Community Health Plan in Ohio, so none is printed for it, an absent figure is not a count of none.

Buckeye Community Health Plan sits at 19.5% in Ohio against 18.7% nationally, and that is the whole of what this page can honestly tell you about your own claim. I am 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 me and I will correct the page.

, Andrew at Axion Labs · hello@getaxionlabs.com
Get my Appeal Kit, $29

Everything you need for your Buckeye Community Health Plan appeal in Ohio: your two deadlines, the argument that fits your denial reason, the letters, the clinician brief, 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.

Where these numbers come from

The Buckeye Community Health Plan figures on this page, the 19.5% denial rate, the 714,834 denials, are this issuer’s own reported rows in that file. CMS did not report an external-review figure for Buckeye Community Health Plan in Ohio in the plan-year 2026 release of the Transparency in Coverage file, which is why no external-review count appears above.

Counts: CMS Transparency in Coverage Public Use File (PY2026 release, PY2024 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).

This page presents federal statistics and a general description of appeal rights created by federal law. It is not legal, medical, or insurance advice, and no outcome is guaranteed. Your denial letter and plan documents govern your specific case. Free help is available from your state's Consumer Assistance Program and from the federal Marketplace at HealthCare.gov.
Problem solved: You have both dates for your Buckeye Community Health Plan notice, you know that Ohio runs the external review itself, and you have the letter, free, on this screen, tonight.

Your words, in a box, read by a person. We ask for no name and no email.