The Insurance Coverage Guide provides useful information in the event you need help getting your insurance to cover the cost of your medication or medical services. The guide explains and describes insurance processes and barriers, namely prior authorizations and appeals. You will also find checklists and how-to steps.
Also included are overviews on how these processes may differ depending on the type of insurance you have (private or government). There is a glossary to help you look up definitions of unfamiliar terms you may come across when dealing with insurance. Also, the guide has a copy of the new Patient Bill of Rights, including government links to more information about the Affordable Care Act.
Insurance Appeals Guide
Many drugs and services will not be paid for by health insurance companies and sometimes they may only pay for a portion. Learn more about what it is, how to file, and the different processes of insurance appeals.
Government Insurance Appeals
Many government insurance programs such as Medicare and Medicaid will deny drugs or services for stroke survivors. Get more information on how to appeal and resources for government insurance programs.
Private or Commercial Insurance Appeals
Private or commercial insurance companies sometimes deny prescription drugs and services. An appeal may have to be initiated if this happens. Learn more on the common processes and steps for private or commercial insurance appeals.
Sometimes prior authorization has to be done before some drugs and medical services can get approved by insurance. Learn more on the process and things to know about prior authorization.
Patient Bill of Rights
It is critical to make informed choices about health care. Under the “Patient’s Bill of Right” there is information about these rights and how to exercise them. Get more information on what they are and the laws behind “Patient Bill of Rights”.
Glossary of Health Insurance Terms
This list is made up of many commonly used terms but isn’t a full list. Some of these terms and definitions may be different from the ones your insurance company uses; in that case, follow your insurance company’s definition. Also, most insurance companies have a glossary like this one on their websites.