Connecticut program
How fast the plan must answer a request
Time limits for an insurer to answer certain requests for treatment approval.
What it is
Time limits for an insurer to answer certain requests for treatment approval.
Waiting for an insurance answer can delay treatment planning. The applicable clock depends on the request and the plan. A request for missing information has its own timing rules.
Eligibility rules
- These Connecticut insurance-review clocks do not govern every plan used in the state. OHA or CID confirms which rule covers the policy and request. Self-funded plans, HUSKY and state-employee coverage require their own governing-rule check.
What you get
- A decision deadline for requests covered by the rule.
- Help with a delay through the Office of the Healthcare Advocate.
What the help covers
- For urgent missing information, the reviewer identifies what is needed within 24 hours and allows at least 48 hours to respond. The decision is due within 48 hours of the response or response deadline, whichever comes first.
- For covered prospective or concurrent requests, the baseline is 24 hours urgent or seven calendar days nonurgent. Specific missing-information and extension rules can change the clock. The clinician can obtain the exact deadline and extension notice in writing.
- If the plan asks for missing information on an ordinary request, you get at least 45 days to send it and the clock pauses meanwhile. The plan can take one five-day extension when something outside its control delays it. (one bullet)
If you decide to apply
- Ask the oncology team when it sent the request and whether it meets the urgent test.
- Ask the plan for its deadline and any missing information in writing.
- Have those dates and messages ready for the Healthcare Advocate if you need help.
The plan; the Insurance Department and the Office of the Healthcare Advocate take complaints. 866-466-4446 · Official page ↗
After you apply
- An approval supplies the decision details the clinic needs. A denial starts a different appeal process.
Good to know
A request for more information changes which clock applies. The plan’s deadline is different from a promise of approval.
Other details
- The Office of the Healthcare Advocate is at 866-466-4446. External review is a separate route when its conditions are met.
Official sources
“If treatment is waiting on insurance, when is the answer due and does the urgent process fit? Could you help us document the request and challenge a delay if needed?”
Why I’m asking: I want to know whether an insurance delay has passed the deadline that applies.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Discuss the benefit and tradeoffs with the social worker. Ask the oncology team when it sent the request and whether it meets the urgent test. Ask the plan for its deadline and any missing information in writing. Have those dates and messages ready for the Healthcare Advocate if you need help.
Your social worker
The oncology team files the request and marks it urgent where it is.
The care team
The doctor says why waiting would harm your child, which is what makes it urgent.
- Who decides
- The insurance plan.
- Ask the care team
- “If treatment is waiting on insurance, when is the answer due and does the urgent process fit? Could you help us document the request and challenge a delay if needed?”
How to apply
First step: Your social worker can help you discuss this route and prepare the request if it fits. Ask the oncology team when it sent the request and whether it meets the urgent test.
- Ask the oncology team when it sent the request and whether it meets the urgent test.
- Ask the plan for its deadline and any missing information in writing.
- Have those dates and messages ready for the Healthcare Advocate if you need help.
Official application / program page ↗
Where it starts: Ask the oncology team to mark the request urgent, and ask the plan in writing what its deadline is.
What to gather
- The date the request was filed
- What the plan asked for and when it was sent
How long: For urgent missing information, the reviewer identifies what is needed within 24 hours and allows at least 48 hours to respond. The decision is due within 48 hours of the response or response deadline, whichever comes first. For covered prospective or concurrent requests, the baseline is 24 hours urgent or seven calendar days nonurgent. Specific missing-information and extension rules can change the clock. The clinician can obtain the exact deadline and extension notice in writing.
What a yes looks like
An approval number and a date, which the clinic can schedule against.
What a no looks like, and the next move
Ask for the reason in writing, then appeal and use the state's external review.
Watch out
- The clinician determines whether a request meets the urgent test.
- Missing information changes the clock under specified rules; it is not an unrestricted restart.
- OHA or CID confirms plan and request scope. These clocks are not a universal HUSKY nursing deadline.
Dates that change this
2026-09-11: OHA or CID confirms which legal clock governs the policy and request. Covered requests have specific urgent, nonurgent, missing-information and extension rules; these are not a universal HUSKY nursing deadline.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
Covered Connecticut insurance reviews generally use 24-hour urgent or seven-calendar-day nonurgent clocks, with specific exceptions.
- $24 — Urgent initial decision
- $7 — Standard decision before the service
- $48 — Urgent decision once additional information arrives
Legal protection: Published decision deadlines you can quote back to the plan
What it costs the family: Free.
The eligibility facts, as published
- Age
- any
- Income
- no income test
- Insurance status condition
- These Connecticut insurance-review clocks do not govern every plan used in the state. OHA or CID confirms which rule covers the policy and request. Self-funded plans, HUSKY and state-employee coverage require their own governing-rule check.
- Residency
- Connecticut
- Processing standard
- 24 hours urgent or seven calendar days nonurgent for covered requests, with specific missing-information and extension rules.
Decisions this site cannot make: The plan applies the clock; the Insurance Department takes complaints
Expect friction on: These Connecticut insurance-review clocks do not govern every plan used in the state. OHA or CID confirms which rule covers the policy and request. Self-funded plans, HUSKY and state-employee coverage require their own governing-rule check. For covered prospective or concurrent requests, the baseline is 24 hours urgent or seven calendar days nonurgent. Specific missing-information and extension rules can change the clock. The clinician can obtain the exact deadline and extension notice in writing.
The trap: Missing-information and permitted extension rules change specific clocks; the insurer must identify the applicable timeline rather than claim an unlimited pause.
Where I read this
- Office of the Healthcare Advocate — Prior Authorization, January 2026 — Connecticut Office of the Healthcare Advocate, read September 10, 2026
- Office of the Healthcare Advocate — Connecticut Office of the Healthcare Advocate, read September 10, 2026