Appeals · 2026
Appeal letter generator.
Create an editable starting draft that addresses the reason stated in your denial notice, requests supporting records, and asks the plan to identify the next review route. The draft does not determine your rights, eligibility, or deadline.
What the draft is designed to document
A plan may compare submitted records with plan terms, written criteria, and the reason stated in the denial. The draft asks the plan to identify the material it used and lets you list records you want considered. Including a request does not establish that a document, remedy, or outcome is available under every plan.
For many employer group health claims, U.S. Department of Labor guidance describes access on request to relevant claim documents and qualified clinical review when medical judgment is involved. Other coverage can follow different procedures. Review the official sources collected on the method and sources page and follow your own notice.
Send it so you can prove it
- Keep a copy of everything you send, including enclosures.
- Use a method that produces a delivery record.
- Ask for written confirmation of receipt, as the letter does.
- Note the date you sent it against your deadline.
If the internal appeal fails
An internal appeal is reviewed through the plan’s process. An eligible external review is handled by an independent reviewer, but eligibility, sequencing, and filing instructions depend on the plan, denial, and applicable process. See the location and plan-type routing aid, then follow the final denial notice.