What Do I Do if I Can’t Get Answers From my Insurance Company?

Sometimes it’s not much fun trying to get answers out of your insurance company. Typically, each time you call, you speak with a different customer service representative and you may get different answers to a question you have. This inconsistency is really frustrating and upsetting, but here are some tips that might help you communicate with your insurer.

But remember when speaking with them:

  • Keep track of your communications.  Make sure that each time you speak with a representative, you are taking clear notes and jot down the date, time, who you spoke with, and the information they provided. Also see if you can get a reference number for the call.
  • Communicate effectively.  Remember that your ultimate goal is to get your questions answered or concerns resolved!  If you are met with resistance by the representative, simply restate your request in a different way. But try to keep calm and respectful, even if frustrated.
  • Be confident. You have the right to complete information regarding your health coverage.  Your insurance company’s customer service representatives are there to assist you, and part of their job includes answering questions to your satisfaction.
  • Don’t be afraid to asset yourself.  If you have tried discussing your question or concern with the customer service representative and still do not feel that your request was handled correctly or appropriately, don’t hesitate to ask for a supervisor.

At the end of the day, if you still don’t feel like your situation is being handled properly, your insurance company isn’t the only resource with all the answers. Get to know these key people who can aid you in your health journey:

  • Your employee benefits manager or human resources personnel
  • Hospital financial counselor
  • State consumers advocacy office (https://www.usa.gov/state-consumer)
  • The Centers for Medicare and Medicaid Services, if this is who you are insured by
  • The U.S. Department of Labor’s Employee Benefits Security Administration if you are insured through an employer-sponsored group plan

Effective communication with your insurance company is critical. Utilize these tips to better work with your insurer and make sure you are receiving all of the benefits you are entitled to.

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