Consumer education · Independent

Your insurance said no. That was the first answer, not the last one.

Free tools that give you your appeal deadline as a real date, the rulebook that governs your plan, and a first letter to send. Built on the plans’ own published criteria and the federal appeal rules.

Every rule cited to a source, with a date We tell you when your appeal will not win No manufacturer or insurer money
this one appealed
Each dot is a denied claim. Fewer than one in a hundred is ever appealed. That is not a statement about how hard appeals are. It is a statement about how few people try.
19%of in-network marketplace claims were denied
<1 in 100denied claims is ever appealed
40%of people know they can demand an outside review

Source: KFF, Claims Denials and Appeals in ACA Marketplace Plans, 2023 data year, published 2025.

Two courses, one method

Start with the one that fits your denial

Both begin with the same free tool. Neither one asks for a card to tell you what your letter says.

Denied a weight-loss or GLP-1 medication

GLP-1 coverage denials

Wegovy, Zepbound, and the rest. Different rules, different criteria, and a Medicare program most people have never heard of.

  • Which of four appeal systems governs your plan
  • Your real deadline, as a date
  • Whether your plan excludes the category entirely, and what works if it does
  • The renewal denial that arrives after the medication works
Free decoder  ·  Full course $99
Read my denial letter, free Or see what the course covers
Denied any other treatment, procedure, or claim

Health insurance denials

Surgeries, imaging, specialists, medications, hospital stays. The original playbook, covering every kind of denial.

  • How to read what your plan actually decided
  • Internal appeals, external review, and the state complaint
  • The document request that gets the plan’s own criteria
  • Letter templates for every stage
Free tool  ·  Full course $79
Get my deadline, free Or see what the course covers

Not sure which? If the denial is about a GLP-1 medication, take the first one. The rules genuinely are different, and the general course does not cover the Medicare GLP-1 program or the renewal criteria.

The method

Most appeals fail because they argue the wrong thing

Most first appeals are a letter explaining how much the treatment matters. That letter cannot be answered, so it gets denied.

What moves a file is mechanical. Your plan has a written criteria document listing numbered requirements. Your denial named one of them. The appeal that works quotes that criterion back, attaches the document that satisfies it, and does the reviewer’s job for them in ninety seconds.

STEP 1 Get the rulebook The plan’s own written criteria document STEP 2 Find the criterion The numbered one your denial actually cited STEP 3 Attach the proof The record that satisfies that exact requirement STEP 4 File it with proof Where it goes, before the deadline, in writing
Get the rulebook. Answer the rulebook. File it where it goes, with proof. That is the whole method, and both courses are that method written out.
What most people never learn

A denial is the first rung, not the roof

Almost everyone stops at the first no. There are four more places to take it, and one of them is decided by people who do not work for your insurer.

YOU ARE HERE The denial RUNG 1 Internal appeal Your plan reviews its own decision RUNG 2 Second level A different reviewer, where the plan offers one RUNG 3 External review An independent body. Its decision binds the plan. THE LEVERAGE RUNG 4 Complaint and employer route Your state regulator, and the employer who wrote the plan in the first place. Almost nobody makes this one. most people stop here

External review is the part that matters

It is not another conversation with your insurer. It is a review by an organization that does not work for them, and the plan has to do what it says.

Deadlines are the part that kills cases

Every rung has one, they are counted differently, and the letter rarely gives you the date. Both free tools work it out for you and tell you the days left.

Which ladder you are on depends on your plan

Marketplace, self-funded employer, Medicare and Medicaid are four separate systems with four sets of rules. Reading the wrong one wastes your deadline.

Why we do this

The gap is not knowledge. It is that nobody tells you it is worth trying.

An insurance denial arrives written to sound final. It uses language that explains nothing, buries the one date that matters, and gives you no idea whether you have a case or are wasting your time. Most people read it, feel bad, and pay or go without.

That reaction is exactly what the numbers reflect. Roughly one in five in-network marketplace claims is denied, and fewer than one in a hundred of those denials is ever appealed. The system is not built to hide an appeals process. It is built so that appealing feels like something other people do.

Let’s Appeal exists to close that specific gap. Not to promise you a win, and not to file anything on your behalf, but to hand you the plan’s own rulebook, the deadline as a real date, the letter already drafted, and an honest read on whether your case is worth the effort.

How we are funded

Course sales, and nothing else. We have no financial relationship with any pharmaceutical manufacturer, pharmacy, telehealth provider, prescriber network, or insurance company, and we take no affiliate commission on anything we mention. When we point you at a competitor’s free tool, which we do, there is nothing in it for us.

What we will not publish

A win rate. We do not have audited outcome data, and any number we printed would be marketing rather than evidence.

When we have real customer results and their permission, we will publish them unedited, and we will say plainly that individual results vary. Until then the space stays empty, which is the honest thing for it to be.

How it works

The free tools are not a teaser

Free · GLP-1 denials

The Denial Decoder

Paste or upload your denial letter and you get the complete read: what your plan decided, which of the four systems governs you, your deadline as a real date with days remaining, an honest assessment of whether the case is winnable, and the most useful thing to do next.

No account, no card. The document is read and discarded.

Free · Every other denial

Your First Letter

Ten questions, about three minutes. Your appeal deadline as an actual date, which rulebook governs your plan, a draft letter built around the reason you were given, and what to attach in what order.

You never upload the letter. You read it and answer questions about it, and what you say about the claim stays in your browser. It asks for a first name and email at the end so it can put your name on the letter and send you a copy.

The paid part

The course is the execution system

Getting the plan’s own criteria document, building the evidence file, making the ask your prescriber will say yes to, writing the letter, filing it with proof, and escalating when the first answer is still no.

Plus the Letter Builder, which drafts your appeal from your inputs and the correct template, and which will not invent a clinical fact.

Our limits, in writing

What we will never do

Promise you an approval

Nobody can sell you that. Anyone who does is lying to you, and you should treat it as the tell that it is.

Help you claim something that is not in your record

Our letter tool refuses, by design. It is insurance fraud, and it is also the fastest way to lose a case you could have won.

Hide the free alternatives

Some of them are genuinely good. Both courses name them and say when you should use one instead of buying ours.

Pretend a hopeless case is winnable

When your plan excludes something outright, the tool says so in the first sentence and points you at what actually works instead.

If money is the problem

Then money is not going to be the reason you lose

The decoders and the first module of each course are free and always will be. Beyond that there is a hardship page: full free access, no documentation, no income proof, and no explanation required. We approve by default.

Somebody fighting to afford a medication should not have to fight to afford the thing that helps them get it covered.