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What Happens When You Appeal Your Denied Care

Last year, more than 60 percent of health plan enrollees who asked the Department of Managed Health Care to review a denial of care from their insurers ended up receiving the medical services they were requesting. In those cases, either the department overturned the insurance company’s decision or the insurer reversed itself after the enrollee asked the department to weigh in. Among California’s three largest insurers, over 64 percent of Anthem Blue Cross enrollees who appealed their denials got the treatment they wanted; nearly 55 percent of Blue Shield of California enrollees did; and about 45 percent of Kaiser Permanente members did.

A new online database created by the Department of Managed Health Care can help consumers size up and compare insurance plans. You can read more about this tool in Ana B. Ibarra’s coverage.