In January 2021, I was in California and needed to go to the emergency room. My insurance plan, based in MA where I worked at the time, covers emergency room visits after a copay. The insurance company denied the claim and following a series of appeals and many phone calls has once again denied it because the 3rd-party company that evaluates claims and appeals denied it saying that my gender on the account is incompatible with the procedures I received.
There is one more appeal remaining which would call for a review by the insurance company itself which previously denied the claim for the same reason: my gender does not match the procedure I received.
When I became a member of this insurance company, I selected the gender that matched the one I am (also the one on my license, birth certificate, etc.) The documents I received did not indicate that choosing one or the other might mean I lose access to some medically necessary services.
The insurance company has said that because I am no longer a member, they cannot update my gender.
Do I have any recourse? Or am I going to be stuck with the > $1k bill that my plan says should have been covered?
submitted by /u/A-passing-thot
[link] [comments]In January 2021, I was in California and needed to go to the emergency room. My insurance plan, based in MA where I worked at the time, covers emergency room visits after a copay. The insurance company denied the claim and following a series of appeals and many phone calls has once again denied it because the 3rd-party company that evaluates claims and appeals denied it saying that my gender on the account is incompatible with the procedures I received. There is one more appeal remaining which would call for a review by the insurance company itself which previously denied the claim for the same reason: my gender does not match the procedure I received. When I became a member of this insurance company, I selected the gender that matched the one I am (also the one on my license, birth certificate, etc.) The documents I received did not indicate that choosing one or the other might mean I lose access to some medically necessary services. The insurance company has said that because I am no longer a member, they cannot update my gender. Do I have any recourse? Or am I going to be stuck with the > $1k bill that my plan says should have been covered? submitted by /u/A-passing-thot [link] [comments]Read Morer/HealthInsurance