Health Appeal

A denial is their first answer. It does not have to be the last.

Health Appeal is free. It reads the rules for your kind of coverage, finds your deadline, drafts your appeal letter, and tells you where to send it. Use it inside your AI assistant, or write your letter right here. You sign it and send it yourself.

When is your appeal due?

Two answers from your denial letter. Nothing you enter leaves this page.

If care is ending this week, the clock is hours, not weeks.

A Notice of Medicare Non-Coverage from a nursing facility, home health agency or hospice has to be appealed by phone before noon on the day before coverage ends. A hospital discharge has to be appealed before you leave. Call the review organization whose number is printed on that notice, today. Care stays covered while they decide.

Most people who appeal, win. Most people never appeal.

In Medicare Advantage, insurers reversed 80.7% of the prior authorization denials that were appealed in 2024. Only 11.5% of denials were appealed at all. On HealthCare.gov plans, fewer than 1 in 100 denied claims is ever appealed.

The reason is not that people agree with the denial. It is that the letter is confusing, the deadline is buried, and nobody tells you what to write. That is the part Health Appeal does.

Figures from KFF analyses of federal data for 2024.

How it works

With an AI assistant it goes like this. Without one, write your letter on this site. It uses the same rules and produces the same letter.

  1. Show your assistant the letter. Take a photo of the denial or paste the text. Your assistant reads it on your side.
  2. It works out your coverage type and your deadline. Medicare Advantage, an employer plan, a marketplace plan and Medicaid all have different clocks and different places to send an appeal.
  3. It drafts your appeal letter. The draft quotes the insurer's reason, answers it, and asks for the things federal appeal rules let people request: the claim file, the criteria used, who reviewed it, and whether software made the call.
  4. It drafts a note to your doctor. A letter of medical necessity from the treating doctor is the strongest thing you can attach.
  5. You review, sign and send. By certified mail, fax or the plan's portal, with proof. It gives you a calendar reminder for the deadline.
  6. If they say no again, it shows you the next level. Independent external review, a state hearing, and the free help that exists for your kind of coverage.

Add Health Appeal to your assistant

It works with Meta's Muse and any AI assistant that supports connectors (also called MCP servers). There is no account and no key. In your assistant's settings, add a custom connector with this address:

https://healthappeal.ai/mcp

Then say:

I got a denial letter from my health insurance. Help me appeal it with Health Appeal.

What Health Appeal is, and what it is not

It is free.
There is no charge to use it.
It is private by design.
The connector is sent a coverage type, a date and a denial category. It never asks for your name, member ID, diagnosis or records, and it has nowhere to store them. Your assistant fills in your details on your side. The deadline check above and the letter builder on this site run entirely in your browser, and nothing you type into them is sent or saved.
It is not a law firm.
Health Appeal gives you information and letter templates. It does not give legal or medical advice, it cannot tell you whether you have a legal claim, and it does not refer you to lawyers. You are the author of your own appeal.
It is not your insurer, and it is not the government.
Health Appeal is independent. It is not affiliated with any insurance company, Medicare, Medicaid or any agency.

The details are in the privacy policy and the terms.

Where the deadlines come from

Every deadline is taken from the federal regulation or program rule that sets it, and counted from the date on your letter.

  • Medicare Advantage (Part C): 65 calendar days. 42 CFR 422.582 (65 day filing window); 42 CFR 422.590 (plan decision deadlines and automatic forwarding).
  • Medicare prescription drug plan (Part D): 65 calendar days. 42 CFR 423.582 (filing window); 42 CFR 423.590 (plan decision deadlines).
  • Original Medicare (Parts A and B): 120 calendar days. 42 CFR 405.942 (120 day window); 42 CFR 405.962 (180 day window for reconsideration).
  • Health plan from a private employer or union: 180 calendar days. 29 CFR 2560.503-1(h)(3)(i) (at least 180 days to appeal); 29 CFR 2560.503-1(i) (plan decision deadlines).
  • Plan bought on HealthCare.gov, a state marketplace, or directly from an insurer: 180 calendar days. 45 CFR 147.136 (internal appeals and external review); healthcare.gov: Internal appeals.
  • Medicaid through a health plan (managed care): 60 calendar days. 42 CFR 438.402(c)(2)(ii) (60 days to appeal); 42 CFR 438.408 (plan decision deadlines; 90 to 120 days for a fair hearing).
  • Federal employee or retiree plan (FEHB or PSHB): 6 months. 5 CFR 890.105 (FEHB disputed claims process); Section 8 of each plan's FEHB brochure.
  • TRICARE (military): 90 calendar days. 32 CFR 199.10 (TRICARE appeal procedures); tricare.mil: Medical Necessity Appeals.
  • Plan from a state, city, school district or church employer: 180 calendar days. 45 CFR 147.136 (applies to most non-grandfathered non-federal government plans); The plan's own booklet or summary plan description.

The complete table, including next levels and fast appeals, is public at healthappeal.ai/rules.json. Rules change. If you see something out of date, write to hello@healthappeal.ai. The date printed on your own notice always controls.