The actions you take depend on the type of health insurance plan you have. For example, you might have an ERISA plan if you get health insurance from a private employer. You need to follow the appeals process for ERISA plans before you take legal action. That said, you may want to contact an experienced health insurance attorney before you file the appeal because this lawyer can help direct your appeal. Learn more about appealing a medical necessity denial with an ERISA plan here. If you have a non-ERISA plan, you have more options. Non-ERISA plans include plans from a government employer, from a religious organization, and more. Learn more about external reviews for non-ERISA plans here. Keep in mind that when an external review upholds your health insurer’s denial, it may be more difficult to get the care you seek.