Writing a Successful Appeal Email for Braces (Free Sample)

Key Takeaways

What You’ll Learn	Quick Answers
Why appeal emails for braces matter	Braces can be denied coverage by insurance; appeal emails can reverse the decision.
What makes an appeal email successful	Clear, professional tone; facts; emotional yet logical reasoning.
Essential components of a great appeal email	Introduction, evidence, supporting details, personal story, and a strong call to action.
3 unique templates to use for inspiration	Professional tone, emotional tone, and evidence-driven tone templates included below.
Pro tips from personal experience	Always include before-and-after photos, quotes from orthodontists, and financial breakdowns.

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My Personal Experience with Appeal Emails for Braces

I first began helping people write appeal emails when my best friend was denied insurance coverage for her teenage daughter’s braces. She was distraught, unable to afford the treatment on her own. 

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I spent hours researching, crafting the perfect email, and eventually, the insurance provider reversed their decision. That success motivated me to help others.

What I’ve learned is that these emails aren’t just about professionalism; they’re about telling a story that insurance companies or financial aid organizations can connect with. 

By blending data-driven evidence with a personal touch, you can dramatically improve your chances of getting the response you want.

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What Makes an Appeal Email Successful?

The key to a successful appeal email is strategy. Your email must balance facts and emotion, while also demonstrating urgency. Here’s a breakdown of essential components:

1. Strong Introduction

• Explain who you are and the purpose of your email.
• Make the reader care by mentioning the personal impact of braces (e.g., health, self-esteem, or financial burden).

2. Supporting Evidence

• Attach professional opinions from orthodontists or dentists.
• Include x-rays, treatment plans, or a breakdown of costs.
• Highlight specific reasons why the denial was unjustified or should be reconsidered.

3. Personal Story

• Humanize the situation.
• Share how braces will impact the patient’s life—boost confidence, improve oral health, or prevent future complications.

4. Call to Action

• Clearly state what you’re requesting (e.g., full coverage, partial assistance, or an appeal meeting).
• Provide a timeline for when you’d like a response.

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Pro Tips from My Experience

1. Use Before-and-After Visuals
   If applicable, include images showing the patient’s current dental issues. Visuals are powerful, especially if they highlight health or aesthetic concerns.

2. Leverage Medical Language
   Use terms like “malocclusion,” “orthodontic necessity,” or “functional impairment” to emphasize medical necessity. These terms resonate with insurance professionals.

3. Stay Polite but Persistent
   Even if you’re frustrated by a denial, maintain a professional and respectful tone. Persistence paired with politeness often yields results.

4. Address Specific Policy Points
   Reference the exact clauses in your insurance policy that support your case. For example: “According to Section 3.4.1 of my policy, medically necessary orthodontic treatment is covered.”

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Template 1: Professional Tone

Subject Line: Appeal for Coverage: [Patient Name] Orthodontic Treatment

Dear [Recipient’s Name],

I am writing to formally appeal the denial of insurance coverage for [Patient Name]’s orthodontic treatment. As outlined in the attached documents, the recommended braces are not merely cosmetic but are a medical necessity due to [specific condition, e.g., severe malocclusion].

Enclosed, you’ll find:

• A letter from [Orthodontist/Dentist Name] detailing the medical necessity.
• X-rays and photos illustrating the current dental issues.
• A copy of the treatment plan and associated costs.

I respectfully request that you reconsider your decision, as braces will significantly improve [Patient Name]’s oral health, confidence, and quality of life.

Thank you for your time and attention to this matter. I look forward to your response.

Best regards,
[Your Name]

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Template 2: Emotional Tone

Subject Line: Help Us Secure Braces for [Patient Name]

Dear [Recipient’s Name],

I am writing on behalf of my [relationship, e.g., daughter, son, or myself], [Patient Name], who desperately needs braces to address [condition]. This situation is not only impacting their physical health but also their confidence and overall well-being.

The denial of coverage has placed us in a difficult position. Without assistance, we cannot afford the treatment that will help [Patient Name] lead a happier, healthier life. Braces are not just about appearance—they will correct [specific issues] and prevent long-term complications.

Please find attached documents, including a medical opinion from [Orthodontist Name] and a detailed treatment plan. I urge you to reconsider this decision with compassion.

Thank you for understanding.

Warm regards,
[Your Name]

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Template 3: Evidence-Driven Tone

Subject Line: Orthodontic Appeal: Evidence Supporting Coverage

Dear [Recipient’s Name],

I am submitting this appeal to request coverage for [Patient Name]’s orthodontic treatment. This case meets the criteria for coverage under [specific clause in the policy], as supported by the attached evidence:

• [Orthodontist Name]’s professional opinion confirming medical necessity.
• Diagnostic records, including X-rays and photographs.
• A treatment plan highlighting the urgency of this intervention.

Failure to address these dental issues promptly may lead to more severe health complications, increasing costs for future treatment. I trust that the provided documentation demonstrates the necessity of approving this claim.

Please let me know if additional information is required.

Sincerely,
[Your Name]

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Real-Life Example

One of my clients, a single parent, had her son’s braces denied due to an incorrect classification of “cosmetic.” Using Template 2, we crafted a heartfelt appeal that included quotes from the orthodontist about the child’s long-term health risks. Within two weeks, the denial was overturned, and her son started treatment shortly after.

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Comparison of Templates

Template	Best For
Professional Tone	Insurance companies or formal entities requiring objective, factual language.
Emotional Tone	Appeals to individuals or organizations with a focus on compassion.
Evidence-Driven Tone	Policies requiring extensive documentation and medical justification.

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Conclusion

Writing a successful appeal email for braces requires a blend of strategy, empathy, and persistence. By following the steps outlined in this guide and using the provided templates, you’ll greatly improve your chances of securing the support you need.