Medical Dental

Insurance questions come with the territory. Here's what to know first.

A denial is not the final word

Ask your insurer for an internal appeal first. If that fails, the Office of Patient Protection arranges an independent review, and over 40% of those reviews are decided in the patient's favor. You have 4 months from the denial letter to ask. External review process (Mass.gov)

MassHealth can back up your other insurance

If your child has MassHealth plus private insurance, the private plan pays first and MassHealth can cover what's left on services it covers. MassHealth and other insurance (Mass.gov)

Ask for prior authorization before you start

Many services and medications need your insurer's approval first. Ask the office to request it before the visit so a denial never becomes a surprise bill.

Say "sensory-friendly" when you book

When you schedule, ask for a quiet first visit or a walkthrough before any treatment. Offices that see kids with disabilities usually have options, but only if someone asks.

General information, not legal advice. Talk with a qualified professional about your family's situation.