Sample Medicaid Appeal Letter

A Medicaid Appeal Letter is a written statement sent to an insurance company to contest their refusal to provide a patient with funds to cover healthcare costs. Whether the insurance provider has decided your income is too high or they do not have enough proof to confirm your disability, you can challenge this denial within a time period mentioned in the letter they send you. A short document that lists the details you may have not shared with the insurer in the past will help you to get an appeal hearing.

You can download a Medicaid Appeal Letter sample through the link below.

Either the patient or their authorized representative can file an appeal - state the name of the patient and their insurance policy number, refer to the denial letter you have received, explain why the patient requires the medical service in question and why, in your opinion, the insurance policy should cover the treatment. Attach this letter to the statement from your medical provider who will elaborate on the necessity of the procedure and publications that refer to the potential success of the treatment to get your point across.

Still looking for a particular document? Take a look at the related samples and templates below:

• Short-Term Disability Appeal Letter;
• Medical Necessity Appeal Letter;
• Insurance Appeal Letter for No Authorization.