Denial of Coverage, One Complaint, 2500+ Families Benefit

Think you can't make a difference? You can. Read this story:

HealthNow, a health insurance company which operates in New York State was fined $1 million this week for denying infertility treatments to as many as 2,500 women across upstate New York. It seems it denied the women payment, despite the fact that state law required them to provide coverage for the treatment.

[A quick clarification: it's not that New York State law requires health insurance to cover infertility treatments; rather, it's because state law requires the company to exclude, in writing, the treatments they will not pay for. There had been no written exclusion for the specific infertility treatment denied.]

What's of most interest to me is the fact that the whistle was blown on this denial by one woman who filed a single complaint. Just one! And now, all those families will benefit. The company will now have to reimburse those women for the treatment.

Also of interest is the fact that because the state began investigating that one violation, they found a number of other violations, too. The ripple effect will include all the other people whose rights were violated by HealthNow.

And, included in the ripple effect, I'm sure, will be further raising of rates and further denial of coverages -- because HealthNow is going to have to get the money to pay its fine somehow.

Bottom line for us patients? If you have been denied coverage, and you believe your claim should be covered, don't just sit back or give up! You pay those premiums to receive a specific list of services from your insurer. Stick up for yourself, fight the good fight, and remember how one lone person took on the system, and won.

(Have you been denied coverage? Does your health insurer refuse to cover your claim? Are you quite sure it's supposed to be covered? Here's how to fight it).
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