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Pumpkin
Underwritten by United States Fire Insurance
Pumpkin offers a single straightforward plan with 90% reimbursement and dental illness coverage included.
4.2
out of 5
Coverage at a glance
Accident waiting period14 days
Illness waiting period14 days
Orthopedic waiting period14 days
Appeal window90 days
Covers dental illnessYes
Covers hereditary conditionsYes
Covers behavioralYes
Covers exam feesYes
What we like
- ✓90% reimbursement standard
- ✓Preventive add-on covers vaccines
- ✓Dental illness included
Watch outs
- ✕Only one reimbursement tier
- ✕Limited deductible options
How to appeal a Pumpkin denial
Pick the reason on your denial letter to get a reason-specific playbook tuned for Pumpkin's policy language and 90-day appeal window.
Insufficient documentation
~75% win rate · low difficulty
Lapsed / inactive policy at time of treatment
~60% win rate · moderate difficulty
Coverage not yet effective / enrollment gap
~55% win rate · moderate difficulty
Curable pre-existing not waited out
~55% win rate · moderate difficulty
Bilateral condition exclusion
~50% win rate · moderate difficulty
Dental illness / dental exclusion
~45% win rate · moderate difficulty
Hereditary / congenital condition exclusion
~45% win rate · moderate difficulty
Not medically necessary / experimental
~45% win rate · moderate difficulty
Out-of-network / non-licensed provider
~45% win rate · moderate difficulty
Specific policy exclusion
~40% win rate · moderate difficulty