Your insurance said no.You don't have to take no for an answer.
Someone in your corner who speaks the healthcare system's language.
If your health insurer denied a medication or treatment, Cove Health can help. We pair you with a licensed physician who reviews your case, identifies the medical evidence that supports your care, and helps you challenge the insurer's decision.
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The healthcare system is complicated. Getting the care you need shouldn't be.
When your insurance company denies your medication or treatment, figuring out what to do next can be overwhelming. The rules are complicated, your doctor may not have the time or resources to fight the decision, and it can be difficult to understand exactly why your care was denied.
That's why Cove Health exists. You shouldn't have to become an expert in healthcare and insurance just to advocate for the care you need.
Insurance rules are complicated
Every health plan has different requirements, policies, and criteria for approving care. Understanding which rules apply to your case can be difficult.
Your doctor has limited time
Your care team is focused on treating patients. Fighting an insurance denial can require time, research, documentation, and follow-up that busy practices may struggle to provide.
Denials can be hard to understand
A denial may say your care is “not medically necessary,” but that doesn’t always tell you why the decision was made or what evidence could help challenge it.
You shouldn’t have to fight alone
When your health and access to care are at stake, you deserve someone focused on your case and helping you understand what comes next.
What did your insurance company say?
Whatever brought you here, you don’t have to figure out what it means or what to do next on your own. Here are some of the common insurance problems Cove Health can help you navigate.
Not sure what kind of denial you have? That's okay.
You don't need to know the insurance terminology before contacting Cove Health. Tell us what happened, and we'll help you understand your next step.
You don't have to figure this out alone. We know what to do next.
When your insurance company says no, Cove Health helps you understand why and what you can do about it. We pair you with a licensed physician who reviews your case, evaluates the reason for the denial, and uses medical evidence and clinical guidelines to help advocate for the care your doctor recommended.
Tell us what happened
Share your denial and information about the medication or treatment your doctor recommended. You don’t need to understand the insurance terminology. We’ll help make sense of it.
A licensed physician reviews your case
Your Cove Health physician reviews the reason for the denial, your medical circumstances, and the relevant medical evidence and coverage criteria to understand the case for your care.
We help you challenge the denial
Your Cove Health physician uses medical expertise, evidence, and Cove Health’s technology to help build a strong case for the care your doctor recommended and guide you through what comes next.
A physician in your corner, backed by powerful technology.
Challenging an insurance denial takes more than filling out paperwork. It takes understanding the medicine, the reason your care was denied, and the evidence that can support your case.
Cove Health brings together licensed physicians, medical evidence, and purpose-built technology to help you navigate the process with someone who knows how to speak the healthcare system's language.
Physician-led advocacy
Your case is reviewed by a licensed physician who can understand the medicine behind your treatment and the clinical issues at the heart of your denial.
Evidence built around your case
We look at the medical evidence, clinical guidelines, and coverage criteria relevant to your situation to help build a well-supported case for the care your doctor recommended.
Technology that strengthens the work
Cove Health’s technology helps your physician analyze the details of your case and identify relevant information more efficiently, so the technology supports the advocacy rather than replacing the human expertise behind it.
Not ready to start a case? That’s okay. Start here.
You don’t have to become an insurance expert overnight. Our guides can help you understand common denials, what they mean, and the steps you can take next.
Physician expertise, strengthened by technology.
Your Cove Health physician doesn't start from scratch. Cove Health's technology helps analyze the details of your case against relevant medical evidence and clinical guidelines, giving your advocate the information needed to build a stronger case.
- ✓Proprietary AI software: purpose-built for healthcare advocacy, not a generic chatbot bolted on.
- ✓A living case database: relevant precedent, refreshed continuously as rules and rulings evolve.
- ✓Local administrative hearings: outcomes and reasoning that show what actually persuades reviewers.
- ✓Human intelligence, always in command: the AI surfaces and structures; a licensed physician decides and signs.
› matching denial type: "medical necessity"
› pulling federal guidelines [7 matched]
› pulling state code + IMR rights ✓
› cross-ref admin hearings 324 cases
› physician review required ✓
› drafting reconsideration letter
See the kind of letter a physician signs.
Every Cove Health letter is physician-signed and grounded in the facts, the applicable guidelines, and the precedent. Here are three illustrative examples. Open any one to read it in full.
Medical Necessity Appeal
Answering a "not medically necessary" denial for advanced imaging, citing federal claims-review rules and state medical-necessity law.
Prior Authorization Request
Requesting approval for an on-label specialty medication, documenting that all step-therapy requirements are already satisfied.
Step-Therapy & Formulary Exception
Requesting an override where the plan's preferred drug is contraindicated or has already failed, with each ground documented.
Samples are illustrative and do not describe real patients.
Getting help is simpler than navigating the system alone.
You bring us what you have. We’ll help make sense of the rest.
Tell us what happened
Share your denial and some basic information about the medication or treatment your doctor recommended. Don’t worry if you don’t know exactly what kind of denial you have.
We review your case
A licensed Cove Health physician reviews your information, the reason for the denial, and the medical and coverage criteria that may apply to your case.
We build the case for your care
Your Cove Health physician uses medical evidence, clinical guidelines, and Cove Health’s technology to develop a clear, well-supported case for the care your doctor recommended.
We help you take the next step
We help you understand what comes next and advocate on your behalf based on the needs of your case.
Ready to have someone in your corner?
Appeal deadlines are set by your health plan and/or applicable law, and you remain responsible for meeting them. Submitting a case does not guarantee that an appeal can be completed or filed before your deadline unless Cove expressly confirms otherwise.
One issue or many, we've got you.
- ✓ Licensed physician review of your records
- ✓ One fully drafted, guideline-cited advocacy letter
- ✓ Sent to the party of your choice
- ✓ No subscription, no commitment
- ✓ Ongoing advocacy across multiple issues
- ✓ Priority physician review
- ✓ Unlimited letters while subscribed
- ✓Continuous case tracking & follow-ups
The membership starts with a two-month minimum commitment. If you cancel during those first two months, the remaining balance for the commitment is still due and will be charged. After the initial two months it continues month to month until you cancel.
Appeal deadlines are set by your health plan and/or applicable law, and you remain responsible for meeting them. Submitting a case does not guarantee that an appeal can be completed or filed before your deadline unless Cove expressly confirms otherwise.
Cove Health provides non-legal patient advocacy. We are not a law firm and do not provide legal representation.
A diagnosis doesn't disappear because a value is missing from a chart. Patients deserve someone who will say so, clearly, and in the system's own language.
Healthcare advocacy, finally on your side.
Cove Health exists because of a real, unmet need. The healthcare landscape is complex, insurance plans are full of variability and nuance, and providers are consumed by day-to-day care. Too often, no one is truly accountable for a patient's outcome.
As healthcare grows more consumer-centric, patients deserve the ability to hire qualified medical professionals to advocate for them, to push, in a non-legal capacity, for what health plans are duly required to provide. Especially when it comes to prior authorizations, medication coverage, and denials of "medical necessity."
That's the need Cove Health fills. We're a health technology company, and we've built something new for it: a category we call Healthcare Advocacy as a Service. Our proprietary AI software does the heavy lifting of research and analysis, and our licensed physicians supply the human judgment, a blend of human and artificial intelligence that delivers cutting-edge advocacy built for the modern era of healthcare. Every patient gets an expert in their corner who knows the terrain, and who puts their case to an opaque committee in the language that committee reads.
Everything you might be wondering.
What exactly does Cove Health do? +
Why would I need an advocate? +
Is Cove Health a law firm? +
Who actually reviews my case and writes the letter? +
What does it cost? +
What kinds of issues can you help with? +
How long does the process take? +
How is my medical information protected? +
Do you guarantee my denial will be overturned? +
How do I get started? +
Still have a question?
You shouldn't have to navigate the healthcare system alone.
Upload your records, tell us who to reach, and let a licensed physician make your case.
Start my case today