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Insurance appeal builder
Your insurer said no. That is not always the end of it. This walks you through the reason on your letter, your deadline, and what to write. It is not legal advice.
How this works
Denial letters can sound final, but HealthCare.gov says you have the right to appeal the decision and have it reviewed by a third party. There is a defined process for challenging a coverage decision, much of it with legal deadlines attached.
It cannot tell you how your appeal will go. What it can do is make sure you are arguing the right thing, to the right people, before the deadline.
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1. What kind of coverage do you have?
This decides which deadlines apply to you.
Read next
- What to do when insurance denies care — the full walkthrough, including external review.
- Questions to ask before treatment begins — including the cost questions worth raising early.
- Find support near you — navigators and advocates who do this for a living.
Deadlines shown here are the federal rules for most non-grandfathered private and Marketplace plans, from HealthCare.gov’s guidance on appealing a health plan decision. Medicare, Medicaid, VA coverage and some self-funded employer plans run their own appeal systems with different clocks. Your denial letter is the authority — if it disagrees with anything here, follow the letter, and tell us at /corrections.