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Life gets complicated.

So does health insurance. Finding the right health plan — and figuring out how to pay for it — can seem like the hardest part of staying healthy.

We are impartial experts who understand health insurance sold in Montana. To put our expertise in your hands, we’ve built a website devoted entirely to health insurance. Called Montana Health Answers, our website provides a detailed look at health insurance in Montana and how to pay for it.

What You’ll Find

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Insurance Not Paying?

If your insurance company initially denies a medical claim, you have a right to appeal their decision. Under federal law, you are entitled to an “internal appeal” and an “external review.” In both instances, the insurance company must re-visit their decision to deny the claim and provide you with a clear, impartial justification for their decision. The appeals process can be confusing. If you are seeking urgent medical care and need prior approval, you may be entitled to an “expedited review” by your insurance company. If you request expedited review the company must complete the process and give you a decision within 72 hours of the request. We put together a fact sheet explaining how both appeals work.

Insurance Problems?
Call us at 1-800-332-6148

Remember: If your insurance policy specifically excludes coverage for a certain procedure, like bariatric surgery, for example, you may not have a right to appeal — even if your doctor says the procedure is medically necessary. The appeals process doesn’t apply to a claim denial for something specifically excluded in the terms of your policy of insurance.

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