NEW What to do When Essential Plan 200-250 Ends
NEW Managing Network Changes with Providers and Hospital Systems
NEW Consumer Guide to Health Insurance Complaints and Grievances
Key Health Insurance Terms: Key Terms
Coverage Denials
If your health plan refused to pay for a medical service or denied a prior authorization request, you have the right to fight the denial through your plan’s appeal process. Here are some Do-it-Yourself appeal guides to help you:
- Medical Necessity DIY: (English) (Spanish)
- Not a Covered Benefit DIY: (English) (Spanish) (Mandarin)
- Out-of-Network Reimbursement DIY: (English) (Spanish) (Mandarin)
- Emergency Services Denial DIY: (English) (Spanish)
- No Surprises Act DIY Appeal Template Letter (English)
For more information, please see: How to Fight a Denial
Resources for Dealing with Medical Bills
If it is determined a bill is your responsibility, the following resources can help reduce the amount owed if you cannot pay:
- Do-It-Yourself Debt Negotiation Packet: (English) (Spanish)
- Fair Medical Debt and Reporting Act: (English) (Spanish) (Mandarin)
- Medical Debt Lawsuit DIY: (English) (Spanish) (Mandarin)
As of November, 2022, a default judgment in a medical debt lawsuit cannot result in your wages being garnished (i.e., taken out of your paycheck) or a lien being placed on your home (i.e., the court cannot take any property you own to repay medical debt). See CHA’s one-pager on the Ban on Liens Wage Garnishments for more information.
For more information on resolving medical bills, click here.
Hospital Financial Assistance
- Hospital Financial Assistance Frequently Asked Questions (English) (Spanish)
- NYS Uniform Hospital Financial Assistance Application (English) (Spanish) (Chinese)
For more information on hospital financial assistance and debt negotiation, click here.
Surprise Bills
Not all bills that come as a surprise are surprise bills! Read more about the Federal NO SURPRISES ACT and New York State’s Surprise Bill and Emergency Services law, their protections for certain out-of-network emergency- and non-emergency care situations, and how to dispute surprise bills:
What to do if you get a Surprise Bill (English) (Spanish) (Mandarin)
Information your plan must give you under the No Surprises Act
Information providers must give you under the No Surprises Act
No Surprises Act DIY Appeal Template Letter