Denied? How to appeal
If insurance says no to a wheelchair, equipment, therapy, or care, you can appeal. Many denials are overturned. Here is how, and who can help for free.
First steps
- Read the denial letter. Find the reason and the deadline.
- Ask your doctor and therapist for a letter of medical necessity. It should say what you need, why, what happens without it, and why cheaper options will not work.
- Send your appeal before the deadline. Keep copies of everything.
- Use the Letter builder for a cover letter.
Medicare appeals
Original Medicare has five levels. Most people only need the first one or two.
| Level | Who decides | Deadline to ask |
|---|---|---|
| 1. Redetermination | The Medicare contractor that processed the claim | 120 days from getting the notice |
| 2. Reconsideration | A Qualified Independent Contractor | 180 days |
| 3. Hearing | Office of Medicare Hearings and Appeals | 60 days |
| 4. Review | Medicare Appeals Council | 60 days |
| 5. Court | Federal district court | 60 days |
Medicare counts the notice as received 5 days after its date. Medicare Advantage plans have their own appeal steps; follow the letter from your plan.
Medicaid fair hearings
- Every state must offer a fair hearing when Medicaid denies, reduces, or stops a service.
- Each state sets its deadline, up to 90 days from the notice. Some are much shorter, so act fast.
- If Medicaid is cutting a service you already get, ask for a hearing right away. In many cases you can keep the service until the hearing if you ask before the date on the notice.
Private insurance
- Ask your plan for an internal appeal. Most plans must give you at least 180 days.
- If the plan still says no, you can usually ask for an external review by an independent reviewer.
Free help
SHIP Medicare counseling
Free, unbiased help with Medicare in every state. Call 877-839-2675.
Your state Protection and Advocacy agency
Free legal help for people with disabilities in every state.
Legal help near you
Legal services in the Atlas.
Good to know: this page is general information in plain language. It is not legal advice. For your own situation, talk with one of the free helpers named on this page.
Last reviewed: October 2026. Laws, dollar amounts, and program rules change. Check with the agency named on this page before you make a decision. Report outdated or wrong information.