Insurance Basics: Your Rights

If Your Plan Doesn't Pay (Appealing a Reimbursement Decision)

Suppose your insurer won´t pay for a healthcare service, or pays less than you had expected. You have the right to “appeal”, or ask for your case to be formally reconsidered.

If Your Plan Doesn't Pay (Appealing a Reimbursement Decision)
The Affordable Care Act

The Affordable Care Act (ACA) of 2010 makes it easier for many Americans to get health insurance. It also expands the services that health plans need to cover.

The Affordable Care Act
Protections for New York Consumers: Understanding Your Out-of-Pocket Costs

By law, consumers living in New York State have certain protections when shopping for and using their health insurance. Your insurer must provide up-to-date information about who is in your network.

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IN AND OUT OF NETWORK

When Out-of-Network Care Can Be Covered in Network
PLAN COSTS

Flexible Spending Plans
YOUR RIGHTS

Appealing a Reimbursement Decision
KNOW BEFORE YOU GO

Choosing Your Healthcare Provider In-Network and Out-of-Network Care

Did You

Know

If your health plan paid less than you expected, you can use your cost estimate to appeal.

Did You

Know

If your plan won't pay for a service, or pays less than expected, you can appeal.