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Depression: when insurers say no, reviewers often say yes

In 256 published external-review decisions involving depression, independent physician reviewers overturned the insurer’s denial 50.8% of the time.

Published decisions
256
2001–2026
Overturned
50.8%
130 denials reversed

Most-fought treatments for depression

What insurers denied — and how those fights ended.
TreatmentDecisionsOverturned
Transcranial Magnetic Stimulation44
59.1%
Provigil21
47.6%
Lexapro12
41.7%
How to use this in your appeal

These outcomes come from California’s external review program — an independent physician panel whose decision binds the insurer. Every state has an equivalent, and internal appeals succeed even more often. If your care for depression was denied, the published record says the denial is worth fighting.

SOURCE: CALIFORNIA DMHC INDEPENDENT MEDICAL REVIEW OUTCOMES (CHHS OPEN DATA) · DERIVED AGGREGATE STATISTICS ONLY · METHODOLOGY

Not legal or medical advice. Coverage Rights is a self-help tool that helps you prepare your own appeal. For advice about your specific situation, talk to a licensed attorney or your doctor.

Fighting a denial for depression? 50.8% won.

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