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.
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.
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.
We often rely on our doctors to tell us what care we need. But to get the best care, you and your doctor should make decisions together. This process is called “shared decision making”.
When Out-of-Network Care Can Be Covered in Network
Flexible Spending Plans
Appealing a Reimbursement Decision
Choosing Your Healthcare Provider In-Network and Out-of-Network Care
If your health plan paid less than you expected, you can use your cost estimate to appeal.
If your plan won't pay for a service, or pays less than expected, you can appeal.
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Insurance Basics: Your Rights
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