Access Sample Letters of Appeal and Medical Necessity below.
Here are two options for accessing these letters:
Download: Click the button to download a Word document with detailed instructions for completing the sample letters.
Open: Click the button to open a new tab with a PDF form featuring blank fields for quick and easy completion.
A template to help guide you when writing a letter of medical necessity.
A template to help guide you when submitting an appeal when coverage has been denied by the plan.