Note: resource links open in a new window:

• A Consumer Guide To Handling Disputes With Your Employer Or Private Health Plan
  The Kaiser Family Foundation provides this useful guide for how to pursue “internal reviews” (the health plan’s own grievance process) as well as “external reviews” (an independent appeals process) of your private health insurance claim denial. The guide also helps explain health insurance coverage and relevant state and federal laws.
• Children’s Rights to Health Care under the MassHealth Program (Fact Sheet)
  Provided by the Disability Law Center.
• How To Appeal A MassHealth Denial (Fact Sheet)
  Provided by the Disability Law Center
• How To Appeal An HMO Denial Of “Medical Necessity”
  External (independent) reviews of an HMO’s (Health Maintenance Organization’s) decision are available through the Massachusetts Office of Patient Protection. External reviews are binding on the health plan. Information on internal grievances and appeals and external review is available here.
• Mass Behavioral Health Partnership Appeals (Fact Sheet)
  Provided by the Disability Law Center.
• Medical Transportation through Mass Health (Fact Sheet)
  Provided by the Disability Law Center.
• Medicaid Recipients have important Fair Hearing rights PDF
  Legal advice on funding AT from Neighborhood Legal Services, Inc.
• Medicare Savings Plans: Covering Part B Premiums and DME Copayments (if QMB eligible) PDF
  This is part of the Protection and Advocacy for AT series created by Neighborhood Legal Services to support AT advocacy.
• Prevention of Decubitus Can Justify the Approval of Wheelchair Accessories and Other DME PDF
  Legal advice on funding AT from Neighborhood Legal Services.
  
  
• Special Education Programs Can Fund School Health Services PDF
  Legal advice on funding AT from Neighborhood Legal Services.
• When AT Does Not Meet Medicaid’s DME Criteria
  Legal advice on using coverage categories other than durable medical equipment (DME) to fund AT (from Neighborhood Legal Services).