Appeals · 2026
Insurance Appeal Deadline Calculator
Miss the window and you lose the right entirely. Enter the date on your denial notice. Which rules apply depends on whether your plan is fully insured or self-funded.
Common questions
Is it worth appealing at all?
Appeals succeed far more often than people expect, yet the overwhelming majority of denials are never appealed. The gap between those two facts is the single strongest argument for filing. An appeal costs you a letter and postage.
Why does fully insured versus self-funded matter so much?
If your employer pays claims from its own funds, ERISA preempts state insurance law and the state external review process does not apply to you. Roughly six in ten workers at large employers are in self-funded plans and almost none of them know it. Ask your HR department or read the Summary Plan Description.
What is the difference between internal appeal and external review?
The internal appeal is reviewed by the insurer itself. External review goes to an independent third party, and its decision is binding on the insurer. You generally have to exhaust the internal appeal before requesting external review.
Can someone file on my behalf?
Yes. You can appoint an authorized representative — often your treating provider, or a family member. It requires written permission, and your plan will have a form.