Strategy / advice for second level appeals – US, privately insured w/ large tech company
I work for a well-known US company with 1 trillion market cap. It is privately insured. I am a young woman, who had to go through chemo and experienced complete hairloss. Although hair pieces or wigs are covered under my plan, the max benefit amount is very small over 12 mo period and spent much more to get something that doesn't look like a halloween costume. I filed an appeal w/ insurance and focused on 1) key features of a quality wig / hairpiece for everyday wear and 2) market pricing, that is in excess of my plan benefit by 3-4x. Further, walking around with unnatural looking hair makes people ask me questions that i do not wish to answer. They denied my claim citing that "you received max reimbursement." I'd like to continue the appeals process. I get that i got the "max coverage" but that max coverage is not determined properly and that part of my argument is completely dismissed. Any advice on how to approach?
submitted by /u/hryu15533
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