Friday, March 23, 2018


I Just Got Denied Coverage: Now What? How to File an Insurance Appeal for Substance Use Disorder

by Garry Carneal, J.D., Senior Policy Advisor with the Kennedy Forum
Insurance coverage denial
If you’ve already gotten your son or daughter into treatment for his or her substance use disorder, the last thing you should have to worry about is how to pay for it. Unfortunately, many insurers automatically deny coverage in part or in whole for addiction treatment, and you may have to appeal in order to ensure that your child continues to receive the treatment he or she needs and deserves.

Families are often faced with the burden of paying out of pocket for their child’s treatment when they are denied coverage. Understandably, the appeals process can seem daunting. However, persistence pays off. While many people don’t know how to (or choose not to) file an appeal, the U.S. Government Accountability Office found that 39 to 59 percent of internal appeals were reversed in favor of the consumer.

To help you understand how to appeal your denial of coverage or payment for substance use disorder, here’s some advice on how to appeal your denial and simplify the process:

Am I allowed to appeal if insurance denies my claim for my child's treatment?

What if my child’s physician says this treatment is medically necessary for my child’s recovery?

Is there anything I can do before filing an appeal?
Read More on How to File an Appeal

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