What to Do If You Have Problems
What options do I have when my health plan refuses to cover the treatment I need?
Your health plan should provide you with the process you need to follow to appeal the health plans decision. In some health plans the only thing you will need to do is to get your doctor to write a letter stating why the treatment is necessary. It can be useful to get the opinion of another doctor, in writing and probably at your own expense, and submit that to the health plan.
In a few states the law gives you the right to complain to an independent reviewer that will make its decision and, if it decides in your favor, has the authority to make the health plan cover your treatment.
Regardless of the law in your state, you will need to go through the health plans appeal process before you can consider taking your health plan to court.
>>What options do I have when my health plan refuses to cover the treatment I need?
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>>Is the health plan legally responsible if I am injured because of a doctors mistake?
>>How can I recover from my health plan for negligence?
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>>What is apparent authority?
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