Content Overview 
- Summary
- Appeal If A Drug Or Treatment You Want Is Denied
- If Appeals Within The HMO Don't Succeed, Explore External Appeals
- If You Still Don't Get What You Want, Consider Complaining To The Regulators, Consumer Organizations And The Press, And/Or Going To Court Or Arbitration.
- If You Have Other Difficulties With The HMO, File A Grievance
- Get Help If You Need It
Summary
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Appeal if you want a drug or treatment or to see a Specialist, and your request is denied.
Be persistent. Experience shows that persistence pays off.
The more information you can gather to bolster your argument, the better. There are times when the sheer weight of a file can help sway an insurer.
If you need help, get it.
If appeals within the HMO don’t succeed, explore external appeals.
If you still don’t get what you want, consider complaining to the regulators, consumer organizations and the press and/or going to court or arbitration.
If you encounter other problems, file a grievance.
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