When your US plan says no
A free PDF to work out what the denial means, and what you can still do about it.
- What each denial reason means, including when a letter is unlikely to help
- Your usual deadlines for appeals and external review
- An appeal, a letter of medical necessity and an external review request
- A note to your employer's benefits team, and a call log
Please don't tell us about your health or your insurance here. We never see what you write in the letters. An appeal may not succeed: plans uphold most of them, and a plan that excludes these medicines may not be open to appeal. Your denial notice and your plan's rules come first. This is for US plans, and it is not legal or medical advice.