An appeal is a request for a formal review of an adverse benefit decision. An adverse benefit decision is a determination about your benefits which results in a denial of service(s), or that reduces of fails to make payment for benefits. This includes denial of part of a claim due to your plan out-of-pocket costs (copayments, coinsurance or deductibles). It also includes retroactive cancellations of coverage.

Your health benefits plan document describes the appeal process and explains the levels of internal appeal available to you. View appeal rights information

Appeals can be submitted by mail by using the Member Service Request Form. 

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