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Appeal rights, steps and free help for a plan type and state

get_appeal_rights
Read-onlyIdempotent

Appeal rights, steps and free help for a plan type and state. For requests like "what are my appeal rights in California?", "my insurer denied my claim, what can I do?" or "how do Medicare appeals work?". Returns who decides, the steps (internal appeal, external review, Medicare levels or Medicaid fair hearing), deadlines, and where to get free help, including the state insurance department. If the plan type is not known, leave it out to get the rules for most private plans.

Input Schema

TableJSON Schema
NameRequiredDescriptionDefault
stateNoUS state name or two-letter code, like California or CA. Puerto Rico works too.
plan_typeNoPlan type: marketplace, employer, employer_insured, employer_self_funded, medicare, medicare_advantage, part_d or medicaid. Everyday words work too, like "job", "Obamacare" or "Medi-Cal". Default: most private plans.

Schema Changelog

Changes observed during successful MCP inspections.

  1. Changed1 schema field changed
    • changedInput schema / properties / plan_type / description
      Previous value: -"marketplace, employer, employer_insured, employer_self_funded, medicare, medicare_advantage, part_d or medicaid. Everyday words work too, like \"job\", \"Obamacare\" or \"Medi-Cal\". Default: most private plans."New value: +"Plan type: marketplace, employer, employer_insured, employer_self_funded, medicare, medicare_advantage, part_d or medicaid. Everyday words work too, like \"job\", \"Obamacare\" or \"Medi-Cal\". Default: most private plans."
  2. First observed

TDQS

A3.9/5.0
Behavior4/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

Annotations already cover the safety profile (readOnly, idempotent, non-destructive, openWorld), so the description's job is to add substance — and it does, enumerating the return contents (who decides, internal appeal / external review / Medicare levels / fair hearing, deadlines, free help) and the default behavior when plan_type is omitted. No auth or rate-limit caveats, but none appear necessary for a public lookup.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness4/5

Is the description appropriately sized, front-loaded, and free of redundancy?

Front-loads the purpose, then examples, then return contents, then the omission rule — a sensible order with no filler. The three example questions are slightly redundant with the opening clause but earn their place by mapping natural user phrasing to the tool.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness4/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

With only two optional, fully documented parameters and no output schema, the description supplies enough to call the tool correctly: the return shape is described and the optionality of plan_type is clarified. Nothing operationally necessary is missing, though the undefined boundary with get_appeal_deadlines leaves minor overlap ambiguity.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters3/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema description coverage is 100%, so the baseline is 3; both parameters are already well documented in the schema, including accepted everyday synonyms and the default. The description's only added nuance is the advice to omit plan_type when unknown, which largely restates the schema's 'Default: most private plans.'

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose4/5

Does the description clearly state what the tool does and how it differs from similar tools?

States a specific resource and scope — appeal rights, steps, and free help — with the qualifiers (plan type, state) that define the lookup. It does not explicitly contrast itself with get_appeal_deadlines, whose territory (deadlines) this description also claims, so sibling differentiation is only implicit.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines4/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

Gives three concrete trigger phrasings ('what are my appeal rights in California?', 'my insurer denied my claim...', 'how do Medicare appeals work?') and a clear instruction for the missing-parameter case. It stops short of naming when to prefer a sibling such as get_appeal_deadlines or draft_appeal_letter.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

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