Life Kit What to do when your health insurance denies coverage
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Sep 18, 2025 Jackie Fortier, a KFF Health News reporter focused on health policy, shares crucial insights on appealing health insurance denials. She breaks down what counts as preventive care and clarifies common billing issues. Listeners learn how to effectively read EOB denials, initiate internal appeals, and gather necessary documentation. If those efforts fail, Jackie discusses options like requesting external reviews and seeking state assistance. This episode equips you with the tools to navigate the often confusing health care system with confidence.
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Preventive Care Is Legally Protected
- Federal law requires many preventive services to be covered with no out-of-pocket cost.
- Eligibility for each service depends on age, sex, and health history.
Wellness Visits Can Trigger Billable Care
- Not all care during a wellness visit qualifies as preventive under federal rules.
- If a problem arises, that portion can be billed separately as diagnostic or office visit care.
Fight The First No
- Don't panic and don't accept the first denial as final.
- Speak up and file an appeal because many denials can be reversed with persistence.