Your Rights

Appeal Rights

If a claim for benefits was denied in whole or in part, you have the right to appeal that decision. This page explains how the appeal process works and the deadlines that apply.

How long you have to appeal

  • You may file an appeal within 180 days of receiving a notice of adverse benefit determination.
  • Appeals of pre-service claims are generally decided within 30 calendar days of receipt.
  • Appeals of post-service claims are generally decided within 60 calendar days of receipt.
  • If your situation is urgent, you may request an expedited review, generally conducted within 72 hours.

Your rights during an appeal

  • Submit additional information and supporting documentation for your claim.
  • Request free copies of documents, records, and other information relevant to your claim, including applicable billing and diagnosis codes.
  • Have an authorized representative file and pursue the appeal on your behalf.

How to file an appeal

Submit your appeal request by mail, email, or phone:

Additional help

For questions about your rights under ERISA, you may contact the Employee Benefits Security Administration at 1-866-444-EBSA (3272).