Denied
$1,200
Out-of-Pocket
Covered
$25
Standard Copay
Why was your medication denied?
Insurers use specific codes and policies to say no. We know exactly how to counter each one.
Step Therapy / Fail First
Insurance wants you to try cheaper drugs before covering the one your doctor prescribed.
Prior Authorization Denied
Missing criteria, paperwork issues, or claims that the drug isn't 'medically necessary'.
Formulary Exclusion
The drug isn't on your plan's covered list. We pivot to a formulary exception strategy.
Forced Switch
Your insurer is forcing you to switch from a working medication to a preferred alternative.
Continuation Denied
They covered it before, but now they won't. We fight for stability and continuity of care.
Quantity / Dose Limits
Your doctor prescribed a specific dose or amount that the plan refuses to cover.
Check if we cover your medication.
Search by medication name or health condition to see if we can help with your appeal.
Try searching for "Dupixent" or "Rheumatoid Arthritis"
How Appealio helps you win.
1. Decode the denial
We analyze your letter to find the specific policy criteria they claim you didn't meet.
2. Collect evidence
We guide you to upload records like PT notes, symptom logs, and doctor's orders.
3. Write the argument
We draft a professional letter citing your plan's own clinical guidelines.
4. Submit & Track
We fax and mail the full packet. You track delivery status in your portal.
What's inside your appeal packet.
A comprehensive, professional submission designed to overturn the denial.
The Appealio Packet
Ready for submission
Legal & Clinical Argument
A clear, evidence-based letter tying your condition to the specific medical necessity criteria in your plan's policy documents.
Evidence Bundle
Medical records highlighted to prove you meet the requirements (e.g. "Step Therapy failed on 10/12/23 due to adverse reaction").
Supporting Documentation
We compile your medical records, letters of medical necessity, and other clinical proofs to support the case.
Sophisticated strategies.
We don't just complain. We use specific regulatory frameworks to force a review.
Criteria-by-criteria rebuttal of the insurer's checklist.
Step-therapy exception framing (documenting failures & intolerance).
Continuation-of-therapy logic to prevent treatment gaps.
Formulary exception pathways for 'not covered' drugs.
Federal parity law arguments for mental health meds.
Deadline management and automatic escalation to external review.
Conditions and medications we currently support.
Browse our complete coverage catalog by category, or search above to find your specific medication.
22
Conditions
92
Medications
227+
Coverage Combinations
Last updated: January 2026
Don't see your medication?
Coverage is expanding. If you don't see yours, request it and we'll take a look.
Patient-led,
provider-supported.
Your doctor wants you to get this medication, but they are buried in paperwork. Appealio makes it easy for them to help you.
We do the heavy lifting
We draft the clinical arguments so your provider can easily support the appeal.
Parallel paths
If your clinic already filed an appeal, our patient-led appeal adds a second layer of pressure.
We track deadlines so you don't have to.
Correct Submission
Fax/Mail
Active Follow-up
Weekly status checks
Escalation
Level 1 → Level 2 → External
Frequently asked questions.
Everything you need to know about medication denial appeals and how Appealio can help.
Start your medication appeal.
Takes ~5 minutes to start. If you're missing documents, we'll help you find them.