My health insurance is through employer, and it is administered by insurance company A. I am in need of a specialty prescription, expensive AF. The plan description document I downloaded from my insurance portal says it is covered, however coverage was denied when pharmacy ran it through insurance.
After some back and forth on the phone with customer service, and then with my HR. I was basically told, ‘oops, the document made an error. the drug is not covered’.
What recourse do I have? Does the plan document carry any weight in legal terms? I assumed the plan document is the equivalent of a legal contract, but they blew it off so lightly.
It is an employer plan, those documents were supposedly filed with government, is there no ramification for filing erroneous documents?
Thanks! It just hurts…I was so happy when reading my document and felt a huge relief that my meds would be covered, and now this…
submitted by /u/Sixoclocklight
[link] [comments]My health insurance is through employer, and it is administered by insurance company A. I am in need of a specialty prescription, expensive AF. The plan description document I downloaded from my insurance portal says it is covered, however coverage was denied when pharmacy ran it through insurance. After some back and forth on the phone with customer service, and then with my HR. I was basically told, ‘oops, the document made an error. the drug is not covered’. What recourse do I have? Does the plan document carry any weight in legal terms? I assumed the plan document is the equivalent of a legal contract, but they blew it off so lightly. It is an employer plan, those documents were supposedly filed with government, is there no ramification for filing erroneous documents? Thanks! It just hurts…I was so happy when reading my document and felt a huge relief that my meds would be covered, and now this… submitted by /u/Sixoclocklight [link] [comments]Read Morer/HealthInsurance