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Appeal a denied health insurance claim — with a letter you can actually send.
Free, copy-paste templates for the whole path — internal appeal, ERISA claim-file request, expedited appeal, external review, and appeals by denial reason — each with what to attach and the deadline to watch.
Not legal, medical, or insurance advice. These are general templates. Confirm the deadline and process on your own denial letter before relying on one.
16 letters & guides
- Start here Health Insurance Appeal Deadlines & Timeframes (ACA, ERISA, Medicare, Medicaid) Free guide to health insurance appeal deadlines: ACA plans generally allow 180 days to file an internal appeal and 4 months to request external review. Compare timeframes. 3 min →
- Start here How to Read a Health Insurance Denial Letter (Codes, Deadlines & Next Steps) Free guide to reading a health insurance denial letter: find the denial reason, code, appeal address, and deadline. ACA plans generally give you 180 days to appeal. 3 min →
- Start here Which Appeal Process Applies to Your Plan (ACA, Employer/ERISA, Medicare, Medicaid) Free guide to finding your health insurance appeal process. ACA plans generally allow 180 days to appeal; ERISA, Medicare, and Medicaid each use a different path. 4 min →
- Internal appeals Request an Expedited (Urgent) Appeal of a Denial Free copy-paste expedited-appeal letter for an urgent health insurance denial. Urgent appeals are typically decided within about 72 hours. Get your doctor to certify urgency. 4 min →
- Internal appeals Appeal a Denied Health Insurance Claim (Internal Appeal Letter) Free copy-paste internal-appeal letter for a denied health insurance claim. ACA plans generally allow 180 days to file. Cite the denial reason, attach support, send. 4 min →
- Internal appeals Request a Peer-to-Peer Review of a Denial Free copy-paste letter to request a peer-to-peer review, where your doctor speaks directly with the plan's medical director. Often must be requested within a short window. 4 min →
- Internal appeals Request Your ERISA Claim File & Plan Documents Free copy-paste letter to request your ERISA claim file, plan provisions, internal guidelines, and SPD — free of charge. Plan documents are generally due within 30 days. 4 min →
- Denial-reason appeals Appeal an 'Experimental / Investigational' Denial Free copy-paste letter to appeal an 'experimental or investigational' denial — counter with published evidence and FDA status. These are often reversed on external review. 4 min →
- Denial-reason appeals Request a Prescription Drug Formulary Exception Free copy-paste letter to request a formulary exception for a non-covered or higher-tier drug. Medicare Part D standard decisions are due ~72 hours. Fill in, send. 4 min →
- Denial-reason appeals Appeal a 'Not Medically Necessary' Denial Free copy-paste letter to appeal a 'not medically necessary' denial — cite the plan's own definition and your provider's letter. ACA plans generally allow 180 days. 4 min →
- Denial-reason appeals Appeal an Out-of-Network / Network Adequacy Denial Free copy-paste letter to appeal an out-of-network denial and get in-network cost-sharing. ACA plans generally allow 180 days. Copy, fill in, send. 4 min →
- Denial-reason appeals Appeal a Prior Authorization Denial Free copy-paste letter to appeal a prior authorization denial — a PA denial is a coverage decision, not a medical judgment. ACA plans generally allow 180 days to appeal. 4 min →
- Denial-reason appeals Request a Step Therapy ('Fail First') Exception Free copy-paste letter to request a step therapy exception — skip 'fail first' when you already failed, can't take, or are stable on the drug. Many states require an override. 4 min →
- Denial-reason appeals Appeal a Timely Filing Denial (Provider Filed Late) Free copy-paste letter disputing patient liability when a provider filed your claim late. A provider's timely-filing error is usually written off, not billed to you. 4 min →
- External review & complaints Request an External (Independent) Review After a Denial Free copy-paste letter to request an external review by an Independent Review Organization. For ACA plans the IRO decision is binding. Usually due within 4 months. 4 min →
- External review & complaints File a Complaint With Your State Insurance Department Free copy-paste complaint to your state Department of Insurance over an unfair denial. Self-funded plans go to DOL/EBSA; Medicare to 1-800-MEDICARE. Fill in, send. 4 min →
Most denied claims are never appealed.
You have real tools — internal and external appeals, the ERISA claim file, expedited review, medical-necessity and prior-authorization appeals. Each letter here turns one of them into a plain, copy-paste template.
FAQ
Are these appeal letters free?
Yes. Every letter is free to read and copy, with no account or paywall.
Is this legal or medical advice?
No. These are general educational templates, not advice for your claim. Confirm the deadline and process that apply to your plan, and consider a patient advocate or attorney.
How long do I have to appeal?
Most ACA plans allow about 180 days from the denial to file an internal appeal, and roughly 4 months for an external review afterward — but the controlling deadline is the one on your denial letter. Medicare, Medicaid, and some employer plans differ.
Internal appeal vs external review?
An internal appeal asks the insurer to reconsider. If upheld, an external review sends your case to an independent organization whose decision is generally binding for ACA plans. You usually must finish the internal appeal first.