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Health Insurance Problems

Has your insurance company refused to pay for your medical services? Learn how insurance companies make claims determinations, how to appeal denials you disagree with, and how to understand coding and your explanation of benefits.

Deductible Too High? How To Budget for a Health Insurance Deductible
Wondering how you'll afford your health insurance deductible? Get strategies to manage your deductible so you'll be able to pay it when it's due.

Balance Billing—How To Handle It
Learn strategies to handle balance billing if you're being billed for the balance due on a medical bill after you and your health insurance have already paid. Don't pay more than you have to.

Balance Billing—What It Is & How It Works
Bigger than expected medical bill? Learn what balance billing is and how it works. Learn when balance billing is legal, and when it’s illegal.

Fighting a Health Insurance Claim Denial
If you use your health insurance, you might run up against a claim denial. It's usually worth fighting your denial. Fortunately, routes are available for disputing claim denials, including getting help from the government in many states. Sometimes your insurer will surrender and pay your claim to avoid the expense of handling an appeal.

How Silly Mix-Ups Cause a Health Insurance Claim Denial
Health insurance claim denials are frustrating, but they're not all disasters. Some are caused by simple mix-ups and are easy to fix. See examples.

What If My Health Insurance Doesn't Cover a Test or Procedure?
To make sure the treatment you need is covered by your health insurance, it is important to know your health plan's benefits. Make sure that you understand your options.

Can’t Pay Your Health Insurance Deductible? What Now?
Need health care but can't afford your health insurance deductible? Get ideas for how to pay your deductible when you can't afford it but you need care.

Insurance Codes - Learn About Insurance Codes to Avoid Billing Errors
Explanation of Benefits, insurance claim forms, and medical bills from your doctor or hospital can be difficult to understand because of the use of codes to describe the services performed and your diagnosis. It may be useful for you to learn about these codes, especially if you have a chronic health problem.

I’m 26 & Getting Kicked Off My Parent’s Health Insurance. What Now?
Losing dependent coverage under a parent’s health plan because you’re turning 26 years old? See your young-adult health insurance options.

Are You Managing Without Health Insurance?
No health insurance? Share your story here. Tell us how you're managing your family’s health care needs and what you've learned that could help others.

Pre Existing Conditions - Have You Been Denied Coverage?
A pre-existing condition can affect your health insurance coverage. If you are applying for insurance, some health insurance companies may accept you conditionally by providing a pre-existing condition exclusion period. What has been your experience?

Customary and reasonable costs
What does "customary and reasonable" cost mean, and how will it affect payment for healthcare services?

Explanation of Benefits - How to Avoid Errors on Your EOB
Your Explanation of Benefits is a window into your medical billing history. Many doctors’ offices, hospitals, and medical billing companies make billing errors. Such mistakes can have serious long-term financial consequences.

Have Your Overpaid? Are You a Victim of Balance Billing?
Balance billing may happen when your health plan pays less than what your doctor or hospital wants to be paid. Your healthcare provider may demand the balance of the bill from you. Learn why this is inappropriate, and what to do about it.

A Consumer Guide to Handling Disputes
This helpful guide walks you through how to appeal a claims denial with your health insurance plan, and then escalate your appeal with your state’s insurance department.

Links to State Insurance Department Websites
You may need your state's insurance department to help you resolve a health insurance claims dispute. Find contact information as well as help for filing claims appeals on your state’s site.

Prepare to Be Uninsured—a Tool Kit for Going Without Health Insurance
Uninsured? Prepare yourself with this tool kit. Get strategies for dealing with problems before they arise. Learn to address the risks you face without health insurance.

Losing Your Health Insurance Because Your Spouse Is Getting Medicare?
If your health insurance comes from your spouse’s job and he or she is going on Medicare, you’ll probably lose your health plan. Learn your options.

What Is a Health Insurance Denial?
Learn what a health insurance denial is, why your health plan might deny a claim or pre-authorization request, and what to do if it happens to you.

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