Little-known fact: When your health insurer denies a treatment or won’t cover a bill, that’s not necessarily the final answer. In most cases, you can appeal that decision.
Even if the insurer says no, consumers can often appeal to an independent group with the power to overrule the company. Nearly a quarter of Washingtonians who do that end up winning.
Our office has posted an easy-to-use guide to filing appeals on its website at www.insurance.wa.gov/your-insurance/health-insurance/appeal. Since we're the insurance regulator for Washington state, it's designed for Washington residents, but many of the tips apply more broadly.
The guide has been recently overhauled to make it easier to use. It includes step-by-step tips, examples, and downloadable letters that consumers can fill out and send to their insurer.
We also experts on staff who can help Washington state consumers with their appeal. They can be reached at 1-800-562-6900 or AskMike@oic.wa.gov.
And if you don't live in Washington state, here's a handy map showing how to contact your state's insurance regulator.