Appeal an Extended Health Benefits decision
Start an appeal
Submit your completed Appeal Request Form and supporting documents by email or fax.
You can start your appeal now. Use the sections below if you need more information before submitting your request.
Important: Appeals must be submitted within 60 days of receiving the decision you want reviewed.
Overview
This page explains how to appeal an Extended Health Benefits decision, what information to include, and what happens next.
Check if this process applies to you
You can request a review if you disagree with a decision about:
- drug benefits
- medical supplies and equipment benefits
- vision care benefits
- dental benefits; or
- medical travel benefits.
You can submit the appeal yourself, or someone authorized to act on your behalf can submit it for you.
Important: If you receive benefits through another plan, such as an employer sponsored benefits plan or private insurance, contact that plan’s benefits administrator directly.
Get ready to submit your appeal
Complete the Appeal Request Form and include any information that supports your request.
Supporting documents may include:
- letters or referrals from an NWT health care provider;
- correspondence related to a denied benefit request;
- financial documentation, where relevant; or
- any other information that supports your appeal request.
Providing complete information helps us review your appeal more efficiently.
Submit your appeal
Understand what happens after you submit an appeal
We review appeal requests within five business days to make sure we have enough information to consider them.
If we need more information, we will contact you.
Once we have enough information, we will review your appeal request and provide you with a written decision.
Appeal timelines
If your appeal is about upcoming medical travel, we will provide a written decision within 10 business days after we receive enough information.
If your appeal is about medical travel that has already happened, we will provide a written decision within 30 business days after we receive enough information.
The written decision will explain the reason for the decision.
This decision is final. There are no further levels of appeal under the Extended Health Benefits appeal process.