How to write an insurance appeal letter
You do not need to sound like a lawyer. You need your numbers, one clear sentence about why, and copies of your proof.
CheckMyDenial team, patient billing and appeals. Published October 2026. Last reviewed 2026-10-29.
How do I write an appeal letter for a denied claim?
Keep it to one page. Put your name, your plan ID number and the claim number at the top, then say plainly that you are appealing the denial and which decision you disagree with.
Add one or two sentences on why, attach copies of your proof, and ask for a written decision. If your plan has its own appeal form, use it and attach your letter. The fill-in letter on this page does the writing part for you. You are not alone, and you do not need any special training to do this.
How long do I have to appeal a denied claim?
Under the rules HealthCare.gov describes, you must file your internal appeal within 180 days (6 months) of receiving the notice that your claim was denied.
Medicare, Medicaid and some other plans can have different deadlines and steps. Your denial letter should say how long you have, so find that date and write it on your calendar today.
What should I attach to my appeal?
Attach a copy of the denial letter, a letter from your doctor if you can get one, and any records or bills that back up your point. Send copies, not originals, and keep your own set of everything.
Keep notes from every phone call with your plan or your doctor: the day, the time, the person's name and title, and what you talked about.
What should I leave out of an appeal letter?
Leave out anger, long life stories and guesses. Leave out originals of your records. Do not send anything you have not kept a copy of. One calm, specific reason beats three pages of frustration.
What happens after I send the appeal?
Here is what usually happens, step by step. Your denial letter and your plan's papers are the final word on the steps for your plan.
- Step 1: Send it and keep proof. Mail or submit your letter the way your plan asks, and keep a copy plus proof of when you sent it.
- Step 2: Wait for the plan's decision. Under the rules HealthCare.gov describes, a standard internal appeal must be finished within 30 days if you have not yet received the care, or 60 days if you already have. Urgent cases move faster. Other plan types can have different time limits.
- Step 3: Read the written decision. The plan must give you its final decision in writing. If it still says no, that letter must tell you how to ask for an outside review.
- Step 4: Ask for an outside review if needed. Under those same rules, you have 4 months from the date you receive that final notice to request an external review. An independent reviewer decides, and your insurer is required by law to accept the result. Your state may run its own review process.
Is there a way to get help with the appeal?
Yes. The Consumer Assistance Program in your state can help, and can even file the appeal for you. You can also text a photo of your denial letter to (213) 606-6303. We read it and reply with where it breaks, free, no account, no form. We are not lawyers, and this is not legal or medical advice.
Your checklist
- Find the deadline on your denial letter and mark it on your calendar
- Copy your name, plan ID number and claim number into the letter
- Write one or two sentences on why you disagree
- Attach a copy of the denial letter and any doctor letter or records
- Keep your own copy of everything and send copies, not originals
- Write down the date you sent it and notes from every call
- Calendar a follow-up call to check on your appeal
A letter you can copy
[Date] [Plan name] Appeals Department [Address from your denial letter] Re: Appeal of denied claim Name: [Your full name] Plan ID number: [ID number] Claim number: [Claim number] Date of service: [Date] Date of denial notice: [Date] To the Appeals Department, I am appealing your decision to deny [the service or item] on the date above. The reason given was: [reason from the denial letter]. I disagree because [one or two plain sentences, for example: my doctor says this care is needed because ...]. I am attaching copies of: the denial letter, [letter from my doctor], and [records or bills]. Please review my appeal and send me your decision in writing. If you need anything else from me, please contact me at [phone or email]. Thank you, [Your name] [Address]
Which rules apply to you?
The steps and deadlines on this page can differ by the kind of plan you have. Your own denial letter always comes first.
- Coverage through a job:ask your HR team whether the plan is “self-funded” or “fully insured.” It can change who you can ask for help. Most private-sector job plans fall under a federal law called ERISA, and the U.S. Department of Labor’s EBSA takes health plan questions at Ask EBSA or 1-866-444-3272.
- Marketplace plan: follow the appeal steps at HealthCare.gov.
- Medicare or Medicaid: each has its own appeal process, listed on your notice.
- Dental-only plan: your plan contract sets the appeal rights, so read it and your letter.
Related answers
Sources: HealthCare.gov: Internal appeals. HealthCare.gov: External review. More in the full appeal guide.
Start here
Have the denial letter? Send it to us.
Text a photo of your denial letter to (213) 606-6303. We read it and reply with where it breaks. Free, no account, no form.
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Free tools for the next step
Keep your appeal papers in one place. Take a photo of your denial letter, EOBs and insurance cards with GetPreCare, so they are on your phone when the insurer or the office asks. Free. Open GetPreCare. Helping a parent or partner? Set it up for them.