Insurance 101: Understanding the Health Insurance Appeals Process
If your health insurance plan denies a medical service because it views the treatment as not medically necessary, you have the right to appeal the decision. Below are tips to help you understand the process.
- If your claim is denied, you are able to appeal the decision within 180 days after the receipt of notice.
- You can appeal the decision by submitting a written request to your health insurance company. They will provide further instructions.
- If the health insurance company denies your internal appeal, you will receive notice from the company. You may be able to request an external review by an impartial independent review organization assigned by the Louisiana Department of Insurance.
Policyholders are entitled to receive continued health care coverage pending the outcome of the appeals process according to the terms of a policy. Our Office of Consumer Advocacy and Diversity can help you navigate the appeals process.
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Ensuring Financial Security
The Louisiana Department of Insurance has partnered with the Insured Retirement Institute to promote National Retirement Planning Week. If you’re getting close to your golden years there are a few things to keep in mind:
Review Your Savings. Make sure you are on track with your financial goals and increase savings if necessary.
Social Security. Try to figure out when you would like to start receiving benefits. Also, review your long-term care insurance and Medicare options.
Lifestyle Adjustments. Retirement may require some changes and downsizing.
A financial planner can help you make smart money decisions. The Louisiana Department of Insurance and the National Retirement Planning Coalition are committed to helping you understand the importance of financial planning. For more tools and resources, visit www.retireonyourterms.org .
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Insurance Tips for Caregivers
Family members serving as the primary caregiver for an aging parent or loved one is becoming more common. The decision usually allows the person receiving care to remain in his or her home. It’s important that families consider insurance needs when caring for a loved one. Caregivers may want to consider obtaining a life insurance policy to help provide support to others in case something happens to them. Disability insurance offers protection by replacing a percentage of previous income. A long-term care insurance policy may be an option to help mitigate costs. Click here to view our Long-Term Care Insurance Information Guide for more information.
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Building an Insurance Career
The Division of Diversity and Opportunity welcomes the following high schools to the InVest program: McKinley High School, Scotlandville Magnet High School, Madison Preparatory Academy, and Eunice High School. InVest is a free program offered through the Independent Insurance Agents and Brokers of America and an outreach program adopted by the Office of Consumer Advocacy and Diversity. The program is designed to promote insurance literacy for high school and college students and to bring awareness of career opportunities. The photo above shows students visiting Blue Cross Blue Shield of Louisiana.
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