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Has anyone appealed to their insurance company to cover out of network?

mom2greatkids's picture
Posts: 528
Joined: Jun 2011

Hi Ladies,

I called my insurance company this afternoon. Since there are no GYN/ONC within my network I can write a letter of appeal. In my area there are four GYN/ONC, but they are all with one clinic, out of my network. I had to go nearly 150 miles for surgery last year.

I have seen an medical oncologist for over a year now. I just would feel more confident with a GYN/ONC. I feel as though I am entitled to see one. OVCA is so scary as we all know.

Anyway, any suggestions as to how I should "word" my letter? The lady at the insurance company said basically to make my argument as to why I should be allowed to see a GYN/ONC.



abrub's picture
Posts: 1865
Joined: Mar 2010

"Laurie The Insurance Warrior" is known for helping get coverage out-of-network. You can google "The Insurance Warrior" to find her. She's a member of another group I'm on, and had to fight her own insurance company in order to get appropriate treatment for her own appendix cancer. Probably worth looking into.

Most insurance companies will let you go out of network if there are no specialists available in-network.

Good luck.

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