How to appeal a health insurance denial
- DenialAppeal is a document-preparation tool for commercial health insurance denial appeals; it is not a law firm and does not file appeals for you.
- A free pre-check may stop the paid Draft Pack path when this tool’s product screening rules do not offer a pack; Medicare and Medicaid users get a public consumer resource card with .gov links instead of a Draft Pack.
Last updated 2026-10-31
Who this guide is for
Commercial and Marketplace denials, including employer and fully insured plans. If the coverage is Medicare or Medicaid, the pre-check shows a public consumer resource card only — start there.
What an internal appeal is
You send a request to the plan using the path on your denial notice. We don’t decide deadlines.
Step by step
- Read the denial notice or explanation of benefits: the reason, claim ID, how to appeal, and any date printed on it.
- Confirm whether the plan is commercial or Medicare or Medicaid.
- If pre-check does not offer a Draft Pack, stop — do not use Checkout to bypass.
- Gather materials you already have: the notice, visit notes, prior-authorization papers, and bills.
- Generate a Draft Pack (letter, checklist, and filing guide) after the pre-check offers one.
- Review every line against your documents and edit as needed.
- Send it yourself using the address, portal, or fax on your notice.
- Keep copies. Ask the plan about next steps after the internal appeal. This tool does not decide external-review eligibility.
Materials checklist
- Denial letter or explanation of benefits
- Member ID
- Provider notes you already have
- Prior-authorization decision, if any
- Itemized bill if the claim is out of network
When pre-check stops
No draft, and no Checkout bypass. Medicare and Medicaid get a public consumer .gov card.
What we don’t do
No filing, no negotiating, and no promise about what the plan will decide.