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Appeal

A request for your health insurance company or the Health Insurance Marketplace® to review a decision that denies a benefit or payment.
  • If you don't agree with a decision made by the Marketplace, you may be able to file an appeal. Small businesses can also appeal Small Business Health Options Program (SHOP) decisions.
  • If your health plan refuses to pay a claim or ends your coverage, you have the right to appeal the decision and have it reviewed by a third party.