Help with Insurance Issues
Sometimes you may need help dealing with health insurance issues. For instance, you might have questions about what your insurance will cover. Or you may need help finding and enrolling in a plan. You might have claim issues with your insurance company if the company pays less than you expected for a service or says it won’t cover a service at all. You can get support for all of these concerns.
Help Finding and Enrolling in a Plan
A number of different people and organizations can help you find a plan and enroll in it. These include navigators, certified application counselors (CACs), agents and brokers. Navigators and CAVs charge no fees for their services. Agents and brokers usually don’t charge fees, but may under certain circumstances.
Help with Insurance Claim Issues
Your health insurance company may say they won’t pay for a service. Or they might pay less than you expected.
- First, talk to your company and ask why the claim was denied or you were paid less than you thought you’d be. It may be due to a simple mistake. If not, you may need to file an appeal with your company.
- If you or your family member has been diagnosed with a chronic, serious or life-threatening illness, the Patient Advocate Foundation (PAF) may be able to help you.
- Many states have a Consumer Assistance Program (CAP). CAPs can help you to understand your rights, file an appeal if your insurance company won’t pay for a service or file a complaint about the company.
- Contact a private patient advocate (claims assistance professional). They can help you with denied claims or payments that are less than you expected. They can also help you file an appeal. Private patient advocates charge for their services.
Sometimes you may need help dealing with health insurance issues. You might have questions about what your insurance will cover, or need support in finding and enrolling in a plan. Or you may have claim issues with your insurance company. For instance, the company may pay less than you expected for a service, or say it won’t cover a service at all. There are many places you can find help for all of these concerns.