WHAT TO DO WHEN YOUR HEALTH INSURER SAYS NO

One in three people get hit with a denial of coverage, but there are smart and effective ways to appeal.

- BY PENELOPE WANG

Your new book, Coverage Denied, shines a light on health insurance claims denials. How common is this issue, and what led you to tackle it?

When I was starting out with new health insurance as a research fellow after getting my doctorate, many of my routine claims for diagnostic tests and prescription drugs were denied. I was overwhelmed navigating the problem, getting rerouted from person to person with my insurer.

I thought, I’m a PhD with the job flexibility to be on hold at two o’clock on a Tuesday. If I’m struggling, what about everyone else?

I started researching and found there were few academic studies on denials. So in 2022, I conducted my own survey of 1,340 Americans with different types of healthcare coverage. Overall, 36% had encountered at least one coverage denial, and nearly 60% of those respondents reported multiple denials.