How to Appeal a UnitedHealthcare Claim Denial

Online: sign in at myuhc.com (or the UnitedHealthcare app), open the claim, and use the appeal/grievance option on the claim detail page. The portal route gives you a submission confirmation — screenshot it.

By mail: use the appeals address printed on your denial letter or Explanation of Benefits. UHC operates many plan types (employer, individual/marketplace, Medicare Advantage, Medicaid) with different appeals addresses — the one on your own letter is the one that's correct for your plan. If your letter lacks one, call the member number on your ID card and get the appeals address, noting the date and representative.

What to include: the appeal letter (identifiers, the exact denial reason quoted, your arguments, the remedy), your physician's letter of medical necessity for clinical denials, and supporting records. UHC commonly resolves appeals it can decide on documents alone — make yours decidable.

You generally have 180 days from the denial notice to file an internal appeal on commercial plans (your plan documents and denial letter control). Standard decisions come within the regulatory windows — generally 30 days pre-service, 60 days post-service — and urgent appeals qualify for expedited decisions in as little as 72 hours.

Some UHC plans provide two internal appeal levels; your final internal denial letter will say whether a second level or external review is next. Medicare Advantage members follow the Medicare appeals track instead (reconsideration, then escalation to an independent review entity) — the denial notice lays out that path.

For denials involving medical judgment, request independent external review — generally within 4 months of the final internal denial; the final denial letter must explain how. The reviewer's decision binds UHC. In parallel, a complaint to your state insurance regulator is free and requires a response; for employer self-funded plans, the U.S. Department of Labor oversees ERISA compliance.