It’s possible to appeal denials of care, but few people try and even fewer are successful, as this KFF explainer points out. But in the rare instances when patients do fight back, it can expose the lengths to which insurance plans may go to hold back medically necessary care.
The following is an excerpt from an extraordinary ProPublica investigation about how one patient and his family fought back against United Healthcare.
Insurance denials don’t always sit well with the individuals within large insurance companies who are tasked with reviewing individual patient cases. Another ProPublica investigation revealed the pressure applied to Cigna’s medical directors to quickly dispense with patients’ requests that their insurance cover doctor-prescribed treatments: