Provide your healthcare provider with these template letters of medical necessity to help them craft a response to your insurance company that gets your immunoglobulin (Ig) replacement therapy approved. Be sure the letter your provider writes includes:
- Your name, insurance ID number, and date of birth.
- The specific product and dosage your provider prescribed.
- The ICD-10 code specific to your diagnosis.
- The medical history that justifies your need for Ig.
- Any circumstances that justify a particular Ig brand or route of administration.
- Your healthcare provider's contact information.
