The action you can take if you disagree with a decision your insurance company has made about your coverage or payment. You can appeal if your health plan denies one of the following:

  • Your request for a health care service, supply, or prescription drug that you think you should be able to get.
  • Your request for payment for health care or a prescription drug you already got.
  • Your request to change the amount you must pay for a prescription drug.
  • You can also appeal if you’re already getting coverage and your plan stops paying.