Home › Guides › How to appeal a health insurance denial
How to appeal a health insurance denial
Step by step: read the reason, check the deadline, gather the documents, write the appeal, and what to do if the plan says no again.
Check my letter free1. Read the reason and the deadline
Your denial letter or Explanation of Benefits must give the specific reason. Most plans give you 180 days to appeal.
2. Ask for your claim file
You can ask, free of charge, for the documents and clinical criteria used to decide your claim.
3. Get your doctor's support
For a medical necessity or experimental denial, a letter from your doctor and your medical records are the core of the appeal.
4. Send the appeal in writing
Send your appeal letter with copies of the documents to the address or fax on the denial letter, and keep proof that you sent it.
5. If the plan says no again
After a final denial, you can ask for an external review by an independent reviewer within 4 months.
More guides
- External review: when the insurer says no again
- How to appeal a Medicare denial
- Letter of medical necessity: what your doctor should include
- Prior authorization denied: what to do
- Emergency room claim denied: your rights