Appeal

Everyone makes mistakes sometimes – including health insurance providers. If your insurer denies a claim (opens in new tab), terminates your plan, or makes a benefits (opens in new tab) decision you believe is incorrect, you have the right to file a formal appeal.

Visit your insurer’s website or call their member services center to get a copy of their grievance form. Once you’ve filled out your appeal information, you’ll need to file the form with your insurer. If you can’t resolve the issue directly, you can escalate the appeal to your state's regulatory commission.

Word to the wise: Before filing an appeal, it’s important to review your Certificate of Coverage (opens in new tab) to check that your insurer actually violated your plan’s policy. You’ll avoid wasting time (and having to fill out annoying paperwork) by doing some legwork up front.