Insurance: tips and resources for appealing

Don't give up:

• Persistence pays off.  Be courteous and consistent in pursuing your appeal, and educate health insurance representatives about your case and psoriasis.
  

Get it in writing:

• Request documentation of coverage decisions or policy information in writing from your insurance company.
  
• Keep copies of correspondence from your doctor and from yourself to the insurance company.
• Submit concerns to your employer's Human Resources department in writing.
  

Take notes:

• Record the names and job titles of the health insurance representatives you speak to and the time and date of your calls.
• Keep a record of any conversations with your health care provider, employer, and state insurance commission regarding the denied treatment.

Get support:

• The manufacturer of the prescribed treatment, whether it is a biologic medication or a home phototherapy unit, may have insurance specialists that can help facilitate your appeal. Check out our financial assistance section for contact information.
• The Patient Advocate Foundation offers assistance to patients with specific issues they are facing with their insurer, employer and/or creditor regarding insurance, job retention and/or debt crisis matters relative to their diagnosis of life threatening or debilitating diseases.
• Contact your State Insurance Commission and speak with a Consumer Advocate about your case.
  

• The Psoriasis Foundation may be able to provide you with a letter supporting your claim. Please fill out our online form, e-mail or fax to 503.245.0626 with the following information:

• A copy of your denial letter
• Name and address
• The name of your health plan
• Patient ID and group plan number
• The name and address of the health plan's medical director/appeals department
• A copy of your health plan's specific medical policy for the treatment of psoriasis
• A brief description of the situation

You may need to ask the plan to accept information from the National Psoriasis Foundation and your doctor as part of your appeal and fill out release of information forms if required.

Resources:

For more detailed information on appealing:

• Kaiser Family Foundation's A Consumer Guide to Handling Disputes with Your Employer or Private Health Plan.
• Families USA Resources for Health Insurance Appeals.
  

Appeal denied? Request an external review.