Question
Does external review apply to all types of insurance policies?
Yes Answer
Incorrect!
The external review process does not apply to specified disease, specified accident, accident only, credit, dental, disability, hospital indemnity, long-term care, vision care, Medicare supplement, workers’ compensation or automobile medical payment plans.
“Grandfathered” health plans—plans that were in existence on March 23, 2010 and have not substantially changed—are also not subject to external review requirements.
If your coverage is obtained through a self-insured plan please contact your employer’s benefits coordinator for information on the appeals process.
No Answer
Correct!
The external review process does not apply to specified disease, specified accident, accident only, credit, dental, disability, hospital indemnity, long-term care, vision care, Medicare supplement, workers’ compensation or automobile medical payment plans.
“Grandfathered” health plans—plans that were in existence on March 23, 2010 and have not substantially changed—are also not subject to external review requirements.
If your coverage is obtained through a self-insured plan please contact your employer’s benefits coordinator for information on the appeals process.
