I’ve been denied medical coverage. How can I file a complaint?

You may find much of the information contained in the section of NAMI’s website on Understanding Health Insurance to be of assistance.  Among the topics, you learn about Are My Insurance Rights Being Violated?How to File an Insurance Complaint and What to do if You're Denied Care by Your Insurance.

The National Association of Insurance Commissioners can connect individuals with state insurance boards for general information regarding insurance laws and filing a complaint against an insurance company for delay in coverage/reimbursement.  The website offers an interactive map online to locate state-specific contact information.

Psych Appeal is the first private law firm in the United States that specializes exclusively in mental health insurance advocacy on behalf of patients and providers (fee-for-service).  Psych-Appeal affiliates with the country’s leading law firms as well as with the Parity Implementation Coalition, the Saks Institute for Mental Health Law, Policy, and Ethics, and Patrick J. Kennedy to curb discrimination against mental illness and to expand access to meaningful treatment.

You may also wish to investigate whether your rejected medical claim is a result of a disparity in medical coverage. The following resources may be of assistance: 

  • The Kennedy Forum offers information about consumer rights to equal insurance coverage for mental health treatment and connects them with essential appeals guidance and resources.
  • ParityTrack provides information to help individuals who have been denied coverage for mental health services (higher copays, limits on the amount of time spent at treatment, high Rx costs, etc.). Go to the a Common Violations section of its website to find out if your rights have been violated. Legal info only- does not provide legal referrals or legal representation).

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