ACA Appeal Process
 

I was reading about changes resulting from the Affordable Care Act (Obamacare) to the appeals process when insurance companies deny coverage and was wondering if anyone had any experience with these new appeals processes. From the information I've read on this board before, it sounds as though appealing insurance companies can be quite a harrowing experience and I'm wondering if any of y'all have gone through under the new reforms and if so how was that experience for you?

I have not gone through that process but my understanding as it stands today if you've been denied continuous coverage for 6 months, states now provide premium coverage for those denied. I believe this will change in 2014 in that no insurance company can deny coverage with a pre-existing condition. This applies to health insurance exchanges in each state.

If you are instead asking about your current health insurer not providing treatment, that would be another issue. In that case I'd sue them in court.

Yep... As of Jan 1, 2014, no insurance company will be able to deny coverage based on pre-existing conditions. I was wondering about the appeals process though as (if your plan is not grandfathered) the process to appeal an insurance company's choice to deny coverage seems a lot easier. Now, if you get denied you can file for an internal (i.e. within the insurance company) review. If you are still unsatisfied after this review you can file for an external review right after that to be completed by an independent party. All of these things have to happen within strict time limits. It seems a lot better from the standpoint of the appealing party than previous processes of appeal, but I was wondering if anyone had any experience...