Empire BCBSDenied Your Medication? Here's How to Fight Back

About Empire BCBS

Empire BCBS serves the New York tri-state area. New York has some of the strongest patient protection laws in the country, including robust external review rights. Use these state protections in your appeal.

Commonly Denied Medications

These are among the most frequently denied medications across all insurers. If Empire BCBSdenied one of these, you're not alone — and there are proven appeal strategies.

How to Appeal a Empire BCBS Denial

1. 1

   Get the denial in writing

   Request the specific clinical criteria and reviewer credentials.

2. 2

   Ask your doctor for a peer-to-peer review

   A direct call between your doctor and Empire BCBS's medical director often resolves denials quickly.

3. 3

   File an internal appeal

   Include a letter of medical necessity, clinical evidence, and your treatment history.

4. 4

   Request an external review if needed

   An independent reviewer examines your case. Their decision is binding on Empire BCBS.