Summer 2022

How to appeal health insurance claim denials

  Overview: Insurance claim denials and appeals  
 
By Ruth Susswein

Consumers almost never appeal when their health insurance claims are denied. Yet, about 40% of ACA Marketplace insurance claim denials were overturned on appeal. Consumer Action looks at the key reasons for denial and how to fight for the coverage you deserve. Read more.
 
  Medicare Advantage claim and care denials  
 
By Ruth Susswein

Medicare managed care plans have been credited with saving money for many enrollees and criticized for, in some cases, delaying or denying necessary medical care. Read more.
 
  Appealing a health insurance claim denial  
 
By Monica Steinisch

A health insurance claim denial isn't the last word. Appealing an unfavorable decision often is well worth the effort--particularly when you follow our tips for a successful appeal. Read more.
 
  Medicare and non-Medicare appeals processes  
 
By Monica Steinisch

The appeals process for Medicare and non-Medicare health coverage differs somewhat, though consumers always have more than one opportunity to make their case. Read more.
 
Consumer Action
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Consumer Action has been a champion of underrepresented consumers nationwide since 1971. A nonprofit 501(c)(3) organization, Consumer Action focuses on financial education that empowers low- and moderate-income and limited-English-speaking consumers to financially prosper.

By providing financial education materials in multiple languages, a free national hotline and ongoing financial services research, Consumer Action helps consumers assert their rights in the marketplace and make financially savvy choices.

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