Health Insurance Companies
Insurance companies regularly deny claims for needed medical care. These denials are for a variety of reasons (and sometimes for no reason at all), including:
Medical care deemed not “medically necessary,” either in whole or in part.
“Balance billing,” where the plan covers up to an “allowable” amount for a service, leaving the patient to pay the full balance of anything which exceeds that amount.
There is no or minimal coverage for out-of-network providers.
There are no available in-network providers.
Out-of-pocket payments that don’t count towards one’s deductible and/or out-of-pocket maximum amount.
Our work focuses on challenging these coverage determinations for all types of care, including mental health care, gender-affirming care, reproductive-assisted treatment, and the many other medical services too frequently denied by insurance companies. We challenge these denials both at the individual level and at a broader, class-wide level in order to address systemic barriers that obstruct access to needed medical care.
