Los Angeles Anthem Pregnancy and Childbirth Insurance Claims Denial

Whether you are newly expecting, due any day now, or already have a newborn at home, you should not have to worry about Anthem paying for your pregnancy and childbirth claims. Unfortunately, many expecting and new parents lose sleep over denied insurance claims.

If you have experienced a Los Angeles Anthem pregnancy and childbirth insurance claims denial, you can take action by contacting a qualified Anthem insurance lawyer. A skilled attorney can thoroughly investigate the policy and the denial to create a strong appeal for the coverage you deserve.

Essential Health Benefits

Prior to 2014, only about 12 percent of insurance plans available on the individual market had maternity coverage. Even some group insurance plans dodged covering maternity care by considering pregnancy a pre-existing condition. Currently, under the Affordable Care Act (ACA), all maternity and childbirth care are considered essential health benefits. This means that all qualified insurance plans must cover these benefits. Even if a patient was pregnant prior to the beginning of the insurance coverage, Anthem must cover these services.

The only exception to maternity and childbirth coverage under the ACA is if a patient has a grandfathered individual plan. These are plans that were purchased by an individual and are not through a workplace. However, Anthem still must adhere to the coverage spelled out in their own contracts.

Insurance Policies as Contracts in Los Angeles

Whether a patient has a grandfathered plan or a plan that falls under ACA laws, an insurance policy is legally a contract. This means that the insurance company is bound by federal and state contract laws.

If an insurance policy states that it provides specific coverage for pregnancy or childbirth services, they are legally required to provide such coverage. If they fail to do so, the patient can seek legal action under contract and potentially ACA laws for an Anthem pregnancy and childbirth insurance claims denial in Los Angeles. A well-versed insurance attorney can examine the policy and determine whether the insurance company illegally denied a claim.

Maternity Coverages

Expecting mothers should receive the following coverage benefits from their insurance company:

  • Outpatient services, such as prenatal and postnatal doctor visits, gestational diabetes screenings, ultrasounds, lab studies, and medications
  • Lactation counseling and breast pump rentals
  • Inpatient services, such as hospitalization, and physician fees
  • Newborn baby care both inpatient and outpatient

Anyone with questions about what benefits new and expectant mothers should be entitled to may benefit from a consultation with a well-versed attorney. They have experience handling Los Angeles Anthem pregnancy and childbirth insurance claims denials and know the rights policyholders have.

Learn More About Anthem Pregnancy and Childbirth Insurance Claims Denials in Los Angeles

No one should have to deal with the stress and worry of a Los Angeles Anthem pregnancy and childbirth insurance claims denial. At a time when new parents should be focused on their families and their health, these claims denials can be extremely stressful.

If you have received a denial of any of your pregnancy or childbirth medical care, an insurance lawyer is dedicated to making the appeals process less stressful. Call today to learn more about an attorney’s denied claims services.