If you landed here, chances are you just got an insurance denial for a treatment you need — and when you came to Claimable for help, we told you we don't support your medication or condition yet.

We know how frustrating that is. You're already dealing with the stress of being denied care your doctor prescribed, and the system is putting up roadblocks at every turn. While we're sorry we can't help you today, we're still here to help break those barriers down.

In this post, we'll explain why we aren't available for every denial just yet – but more importantly, what you can still do to fight for the coverage you deserve.

Why We Don't Support Everything (Yet)

Every condition and medication on the Claimable platform has a fully validated appeal strategy behind it. Our team researches and pressure-tests specific clinical guidelines, laws, insurer policy language, and denial patterns, building them into the platform before we'll generate a single appeal for a patient. That research is what allows us to create strong, powerful appeals from millions of possible strategy combinations rather than producing a generic letter.

We take seriously that what we create could determine whether or not you get treatment. An appeal built on the wrong argument, a misapplied citation, or a legal standard that doesn't apply to your plan type can mean another denial. When winning an appeal can mean the difference between getting care and going without it, it's critical to us to make sure every appeal we support meets a high bar for accuracy and quality.

So we don't support everything – just yet. We're always adding support for more medications and conditions, and our hope is that someday soon, Claimable can be used to appeal every single denial in the American healthcare system (all 850 million of them!). But until that day comes, we're still here to help you get covered however we can.

What Makes a Strong Appeal

Whether you use Claimable, write your own appeal, or use another tool, the strongest appeals combine three things: your personal health story (how the denial is specifically affecting your life and function), clinical evidence (guidelines and studies from recognized medical societies that support your treatment), and policy and legal analysis (the specific plan provisions and laws that apply to your denial type and plan type). When all three work together, that's when denials are most likely to be overturned.

The specifics matter more than most people realize. A formulary exclusion denial and a medical necessity denial for the same medication require fundamentally different strategies: different clinical evidence, different legal arguments, even a different tone. A formulary appeal needs to demonstrate that no therapeutically equivalent alternative exists for you specifically, while a medical necessity appeal needs to dismantle the insurer's rationale for why your treatment isn't needed. The legal protections available to you depend on your plan type and state.

The TLDR? Getting it right is important. That's what we're built to do, and in the meantime, we've put together some resources to help.

What Can I Do Instead of Claimable?

The good news: you have the right to appeal regardless of whether Claimable supports your condition. That right comes with real protections most patients don't know about — mandated response timelines, multiple levels of review, and for most plan types, the right to an independent external review where someone outside your insurance company evaluates your case.

Here's where to start:

Download Our Sample Appeal Letter Template → Follows the three-pillar structure with prompts for your personal details, clinical evidence, and legal arguments.‍

10 Essential Patient Appeal Rights Every Patient Should Know →
Breaks down the specific legal protections you have when appealing a denial — including rights most patients don't know exist.

How to Get a Non-Formulary Drug Covered →
If your denial is formulary-related, this guide walks you through the exception request and appeal process step by step.

Why You Should Appeal Your Insurance Denial Yourself →
Patient appeals carry legal protections that provider appeals don't. This post explains why — and how to use that to your advantage.

Find Your State Department of Insurance →
Every state has one, and they exist to help people in your situation. They can tell you your exact review rights and intervene if your insurer isn't following the rules.

ProPublica's Claim File Helper →
Free tool that generates a letter requesting your claim file — the internal notes, correspondence, and records your insurer used when deciding to deny you.

HealthInsuranceAppeals.org →
Led by attorney D. Brian Hufford, this organization partners with law schools to provide free pro bono assistance to patients appealing health insurance denials.

Patient Advocate Foundation →
Offers case management for patients navigating insurance denials.

Ask your doctor's office about submitting a peer-to-peer review request or letter of medical necessity alongside your appeal. A patient appeal and a provider appeal working in parallel create pressure from two directions – and if one is denied, the other keeps going.

Thinking About Using ChatGPT or Another AI Tool?

We say: go for it. Using an AI tool to draft your appeal is far better than not appealing at all. But don't treat its output as final – AI language models make mistakes that aren't always obvious, and in an appeal, accuracy matters. This applies to general-purpose AI like ChatGPT and Gemini, as well as many broad insurance AI tools that build appeals off of general statements instead of specific medical information. Before you submit anything AI-generated:

Check that every clinical study cited actually exists. Search each one by title in PubMed or Google Scholar. AI tools routinely fabricate convincing-looking citations that aren't real, and a fabricated citation undermines your credibility with the reviewer.

Confirm that laws and regulations referenced are real and apply to your plan type. AI tools will cite statutes that don't exist or apply federal protections to plans they don't cover. Look up anything the tool references.

Make sure the appeal addresses your actual denial reason. Medical necessity, formulary exclusion, and step therapy denials each require fundamentally different arguments. If the tool argues the wrong one, the strongest evidence in the world won't matter.

Verify that clinical guidelines are current and from recognized medical societies. Outdated guidelines can work against you if the reviewer is using the current version.

Be careful with your personal health information.Your appeal will include sensitive medical details — your diagnosis, treatment history, medications, and how your condition affects your daily life. Before entering any of that into an AI tool, understand how that tool handles your data. Most general-purpose AI chatbots are not HIPAA-compliant, which means your health information may be stored, used for model training, or accessible in ways you didn't intend.

You might be thinking… isn't Claimable powered by AI? The difference is that our AI is purpose-built for insurance appeals. We use a human-in-the-loop model and multiple quality check gates that cross-reference our database for accuracy, strategy alignment, and argument soundness. Plus, we're HIPAA-certified and SOC 2 compliant: Your data is fully encrypted and handled under the same privacy standards your doctor's office is required to follow.

We're Adding Support for More Appeals All the Time

Our team is continually researching and validating appeal strategies for new conditions and medications. The 85+ medications we support today are growing – and our goal is to be there for every patient who needs to appeal a denial, no matter what treatment they've been denied.

If you'd like to be notified when we add support for your condition, sign up updates here. We'll let you know the moment we can help.

In the meantime: you have the right to appeal. The process is stacked against you on purpose — insurance companies count on the complexity being enough to make you walk away. Nearly half of patients do. But the ones who appeal, with the right evidence and the right arguments, overturn denials at dramatically higher rates than most people expect.

Your denial isn't the final answer. It's the first move in a process that's designed to have a next step. Take it.