Health insurance helps with the cost of general health care and helps individuals protect themselves and their families against illness, injury and accidents. You may receive health insurance coverage from an employer, or purchase insurance for yourself and your family through an agent or the online Health Insurance Marketplace. When selecting a policy, make sure to find out which contracted hospitals, facilities and health care providers are in your insurance company's network.
Our Office of Consumer Services can assist with questions or help you if you choose to file a complaint against your insurance company.
Consumer Health Appeals
The Louisiana Department of Insurance does not make determinations of medical necessity. However, if your health insurance plan denies a medical service because it views the treatment as not medically necessary, you have a right to appeal the decision with the health plan. If your health insurance plan denies you a medical service, it must inform you of the available internal and external appeals processes.
You also have the right to review and have copies of all documents relevant to the claim for benefits turned over to you free of charge and to submit comments and documents relating to the claim. You are also entitled to receive continued health care coverage pending the outcome of the appeals process according to the terms of your specific policy.
If you have questions about navigating the appeals process, please contact the Louisiana Department of Insurance Office of Consumer Advocacy and Diversity.