An appeal is your formal request for a health plan to look again at a decision you disagree with, such as a denied service or an unpaid claim. Appeals usually start inside the plan itself and, if that fails, can move to an independent outside reviewer. A well-documented appeal explains why the care is medically necessary and points to the plan's own coverage rules.
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Disclaimer: This definition is provided for general educational purposes only and is not legal, medical, or insurance advice. Insurance rules, deadlines, and terminology vary by plan, state, and over time. Always check your own plan documents and confirm current details before acting.