How to appeal an Aetna denial

To appeal an Aetna denial, file an internal appeal within 180 days of the date on the denial letter; Aetna returns standard decisions in 30 days, and if it upholds the denial you can request an independent external review within 4 months. Pick your treatment below for a step-by-step guide.

Appeal guides by treatment

Each guide covers the Aetna-specific filing window, decision timeline, common denial reasons, and how to submit your appeal.

• Aetna glp-1 weight-loss drugs denial →
• Aetna mental health & behavioral health denial →
• Aetna fertility & ivf denial →
• Aetna adult adhd medications denial →
• Aetna specialty biologics denial →
• Aetna cancer treatments denial →
• Aetna ms treatments denial →
• Aetna surgery denied as 'not medically necessary' denial →
• Aetna out-of-network emergency denial →
• Aetna migraine cgrp inhibitors denial →
• Aetna pediatric therapy denial →
• Aetna continuous glucose monitors & insulin pumps denial →
• Aetna genetic testing denial →
• Aetna hepatitis c cures denial →
• Aetna sleep medicine — cpap, bipap, asv, oral appliances, inspire hns denial →
• Aetna dme — wheelchairs, prosthetics, orthotics denial →
• Aetna dental — medical necessity, oral surgery, tmj, cleft palate denial →
• Aetna interventional pain — scs, rfa, esi, kyphoplasty denial →
• Aetna substance use disorder treatment (sud/moud) denial →
• Aetna rare disease — ert, substrate reduction, gene therapy denial →
• Aetna hiv prep & hiv treatment denial →
• Aetna hearing aids, cochlear implants, baha denial →
• Aetna hemophilia & bleeding disorders denial →
• Aetna cystic fibrosis & pulmonary fibrosis denial →
• Aetna cardiology drugs denial →
• Aetna cardiac devices & procedures denial →
• Aetna neurology — alzheimer's, parkinson's, als, epilepsy denial →
• Aetna sickle cell & thalassemia denial →
• Aetna vision & retinal — anti-vegf, ga, gene therapy denial →
• Aetna kidney disease — ckd, esrd, igan, adpkd denial →
• Aetna endocrine (non-diabetes) denial →
• Aetna liver (non-hcv) — nash/mash, pbc, aih, wilson denial →
• Aetna women's health — menopause, endometriosis, pcos, ppd denial →
• Aetna copd severe + alpha-1 antitrypsin deficiency denial →
• Aetna diabetes drugs & insulin denial →
• Aetna asthma & severe allergies denial →
• Aetna orthopedics & sports medicine denial →
• Aetna gerd & severe reflux denial →
• Aetna ibs & functional gi denial →
• Aetna eating disorders — residential / php / iop denial →
• Aetna osteoporosis denial →
• Aetna long covid / pasc denial →
• Aetna severe acne denial →
• Aetna eosinophilic esophagitis (eoe) denial →
• Aetna iv iron infusion denial →
• Aetna hereditary angioedema (hae) denial →
• Aetna compounded glp-1 denial →
• Aetna pediatric oncology denial →
• Aetna maternity & postpartum denial →
• Aetna stroke & neuro rehab denial →
• Aetna lupus & rheumatology denial →
• Aetna chronic wound care denial →
• Aetna immune globulin (ivig/scig) for pidd denial →
• Aetna adult car-t cell therapy denial →
• Aetna myasthenia gravis & cidp denial →
• Aetna pulmonary hypertension denial →
• Aetna amyloidosis (cardiac attr + al) denial →
• Aetna spinal muscular atrophy denial →
• Aetna autoimmune cytopenias (itp + aiha) denial →
• Aetna c. difficile infection denial →
• Aetna solid-organ transplant denial →
• Aetna men's sexual health — trt + ed denial →
• Aetna treatment-resistant depression — rtms, spravato, ect denial →
• Aetna inflammatory bowel disease (crohn's + uc) denial →
• Aetna plaque psoriasis + psoriatic arthritis denial →
• Aetna atopic dermatitis (ad / eczema) denial →
• Aetna glaucoma (drops + procedures + surgery) denial →
• Aetna multiple myeloma (non-car-t) denial →
• Aetna prostate cancer denial →
• Aetna melanoma & melanoma-immunotherapy denial →
• Aetna pediatric epilepsy denial →
• Aetna growth hormone replacement therapy denial →
• Aetna bph procedures + medical therapy denial →
• Aetna lymphoma & leukemia (heme malignancies) denial →
• Aetna bone marrow transplant (allogeneic hsct) denial →
• Aetna neurosurgery — discectomy, laminectomy, craniotomy, shunt denial →
• Aetna radiation oncology — proton, sbrt, brachytherapy, imrt, iort denial →
• Aetna thyroid eye disease (ted) — tepezza (teprotumumab) and igf-1r therapy denial →
• Aetna compounded medications (non-glp-1) — bhrt, ldn, ketamine, custom-dose pediatrics denial →
• Aetna ent / otolaryngology — sinus surgery, septoplasty, tonsillectomy, head & neck denial →
• Aetna vascular & endovascular — aaa, carotid, pad, varicose veins, ivc filters denial →
• Aetna bariatric surgery — rygb, sleeve, duodenal switch, sadi-s, revision, esg denial →
• Aetna interventional radiology — ufe, pae, tips, y-90, tumor ablation, kyphoplasty denial →
• Aetna neuropsychological & psychological testing — adhd, tbi, dementia, asd, presurgical eval denial →
• Aetna mohs surgery & dermatologic surgery — bcc, scc, melanoma in situ, slnb, pdt denial →
• Aetna pediatric subspecialty — cardiology, gi, pulmonology, rheumatology, endocrinology, neurology denial →
• Aetna reconstructive plastic surgery — lymphedema, panniculectomy, burn, mohs, hand denial →
• Aetna inpatient rehab — irf / snf / ltac admission and length-of-stay denial →
• Aetna hospice / palliative — eligibility, gip, recertification, concurrent care denial →
• Aetna home healthcare — home nursing, home infusion, home pt/ot/slp, home aide, hospital-at-home denial →