How to write an appeal letter to your insurance company:

In many cases, you will need to send a written letter to your insurance company to request an exception to step therapy requirements. If your doctor is willing to write a letter on your behalf, including it with your appeal can be helpful. Template letters for you and your doctor are available for download below. 

After you have downloaded both letters, do the following:

  1. Add your own information in each of the placeholders – those are (IN CAPITAL LETTERS INSIDE PARENTHESES) throughout the templates.

  2. In the template for your doctor, you will be able to fill in most of the information. Once you have filled in all of the sections that you can, be sure to send the letter to your doctor to complete and sign.

  3. Once you have both completed letters, print two copies and sign them.

  4. Send a copy of both letters to your doctor (he or she can add them to your chart for reference).

  5. Send a copy of both letters to your insurance company.

Before you begin you will need a few things with you:

  • Your insurance membership card – this will have policy numbers, etc. on it.

  • Your records of your doctor visits, medications used, symptoms experienced, etc. You’ll want to have a copy of each of these to include with your letters when you send your appeal to your insurance company.