A denial letter is not the final word.
Roughly half of internal appeals are overturned, yet most people never file one. Upload your denial letter and get a clear read on whether your case is appealable, what evidence wins, and the exact deadline you are working against.
Free analysis in under a minute. No account, no card, no spam.
You are not alone in this
The numbers most insurers would rather you did not see, sourced from KFF and CMS marketplace reporting.
What you get before you pay anything
We extract the policy cited, the reason code, and the appeal deadline so you know exactly what you are dealing with.
If your case is weak, we say so. We would rather tell you the truth than draft a letter that will not win.
Plain language, three pages or fewer, structured around your insurer's own clinical policy. You stay in control.
No medical advice, no legal advice. Just the next step, in your words, on your timeline.
Appeal in 4 steps
- Step 1Read the denial letter
Find the policy or rule cited. It names the medical policy bulletin that drove the decision and the deadline for appeal.
- Step 2Gather records
Office notes, imaging, labs, prior therapy history, and a letter of medical necessity from the treating physician.
- Step 3Draft the appeal letter
Three pages or fewer. Cite the policy by name. Map each criterion to your records. Attach supporting evidence.
- Step 4Submit and track
Send by certified mail and through the member portal. Internal appeals decide within 30 to 60 days. Expedited cases within 72 hours.
Appeal windows by insurer
Federal rules set 180 days for most ERISA and marketplace plans. State-regulated plans and Medicare Advantage differ. Confirm against your denial letter.
| Insurer | Internal appeal | External review | Expedited |
|---|---|---|---|
| UnitedHealthcare | 180 days | 120 days | 72 hours |
| Anthem Blue Cross Blue Shield | 180 days | 120 days | 72 hours |
| Aetna | 180 days | 120 days | 72 hours |
| Cigna | 180 days | 120 days | 72 hours |
| Humana | 180 days | 120 days | 72 hours |
| Kaiser Permanente | 180 days | 120 days | 72 hours |
| Blue Shield of California | 180 days | 120 days | 72 hours |
| Molina Healthcare | 180 days | 120 days | 72 hours |
By insurer
All →By drug (prior auth)
All →Upload the EOB. Get a one-page read on whether your denial is appealable, what evidence wins, and the deadline you are working against.
Common questions
How long do I have to appeal a denied health insurance claim?+
Federal rules give you 180 days from the date of denial to file an internal appeal on ERISA group plans and marketplace plans. After the final internal denial, you have 120 days to request external review.
Do I need a lawyer to appeal?+
Not for most internal appeals. A self-help appeal works when it cites the insurer's own clinical policy and maps your records to its criteria. For complex denials after external review, an attorney can help.
What is the success rate for health insurance appeals?+
Government data (CMS marketplace plan reporting) shows roughly 40 to 60 percent of internal appeals are overturned. External review reverses a further share. Most denied claims are never appealed at all.
Can I get an urgent decision?+
Yes. If waiting would seriously jeopardize your health, you can request an expedited appeal, which must be decided within 72 hours. The treating physician submits a written statement supporting urgency.
What documents do I need?+
The denial letter (EOB), your member ID, the relevant office notes, imaging or lab reports, a letter of medical necessity from the treating physician, and the insurer's clinical policy bulletin that drove the denial.