Health Insurance

Senator Lieberman's Constituent Service Center regularly receives the following questions regarding insurance. If your question is not answered here, please send an email so that his staff may address your concern.  For questions about the implementation of health care reform and how it applies to you, click here.

• Can Senator Lieberman assist me in resolving a claim problem with my health insurance provider?
• Whom can I contact for more information and assistance about my insurance complaint?
• Where can I get help paying for my cancer treatment?

Q: Can Senator Lieberman assist me in resolving a claim problem with my health insurance provider?

If your health insurance provider denies a payment claim, most insurance plans have a two step appeals process. Your health insurance plan manual will outline the internal claim appeals process which, under most circumstances, must be done with a written letter.

If you have exhausted your health insurance plan's internal appeals process and are a Connecticut resident, you may file an external appeal under certain circumstances only.  Please contact the Connecticut Department of Insurance for information about the external appeals process.

The external appeals process is not available to people who work for companies that are self-insured, or who are in a Medicare or Medicaid program. Individuals who are covered by self-insured health plans should call the U.S. Department of Labor Employees Benefit Security Administration at (866) 444-3272. Individuals who work for municipalities or government agencies that are self-insured and have a health care dispute may contact the Connecticut Insurance Department's Consumer Affairs Unit at (860) 297-3900 or toll free 1-866-203-3447 for a referral on where to obtain assistance. The Connecticut Insurance Department will refer qualified appeals to one of several organizations for dispute resolution.

The Connecticut Insurance Department will refer qualified appeals to one of several organizations for dispute resolution. Consumers must file an appeal within 30 days of receiving written notice from their health insurance plans that the internal appeals process has been exhausted.

Q: Whom can I contact for more information about my insurance complaint?

Please contact the Connecticut Insurance Department to request an external appeals application and to determine the filing fee by calling 800-203-3447.

You may also wish to contact the State of Connecticut Office of Managed Care Ombudsman. The Office of Managed Care Ombudsman can assist Connecticut residents who belong to managed care/HMO health plans. If you have questions about managed care, the referral or pre-authorization process, or the appeals/grievance procedures, the Office of Health Care Advocate can provide help. You can contact the Office of Managed Care Ombudsman at 866-HMO-4446.

If you would like more information, please visit the Office of the Health Care Advocate or call toll-free at 1-866-HMO-4446.

Q: Where can I get help paying for my cancer treatment?

The CancerCare Co-Payment Assistance Foundation is a not-for-profit organization established to address the needs of eligible individuals who cannot afford their insurance co-payments to cover the cost of medications for treating specific cancers. The program now lists seven diagnoses eligible for assistance: breast cancer, colorectal cancer, head and neck cancer, non-small cell lung cancer, pancreatic and renal cancer and glioblastoma. The cutoff for assistance is 400% of the federal poverty level—slightly above $43,000 for an individual and $58,000 for a family of two. Some diseases have a $10,000 annual limit on aid, others have a $5000 limit.

Please contact The CancerCare Co-Payment Assistance Foundation at 1-866-55-COPAY (866-552-6729), information@cancercarecopay.org. or www.CancerCareCopay.org.