The insurer determined you do not meet the plan eligibility criteria for this service. This could be age, enrollment status, or other requirements.
Review the eligibility requirements for this service in your plan documents. If you believe you meet the requirements, appeal with documentation of your eligibility. Contact your HR department if this is an employer plan.
Appeal outlook: Moderate with documentation
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Read articleWhat to Do When Insurance Denies a ClaimInsurance denied your claim? Learn the exact steps to appeal a health insurance denial in 2026, from reading the denial letter to external independent review.
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