Are ins companies required to cover annual mammograms for women 60+?

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Are ins companies required to cover annual mammograms for women 60+?

I am 61 and live in AZ. I had my annual mammogram in march. My insurance company does not seem to pay for cover it this year. I emailed them 3 times, 1-the claim was denied, 2-the denial was an error but they still denied it, 3-they stated that I was covered but still denied.I spoke with cust service, they agreed that I was covered forwarded the claim to processing where it was denied again. I don’t think this is correct, legally what can I do?

Asked on June 1, 2009 under Insurance Law, Arizona

Answers:

B. B., Member, New Jersey Bar / FreeAdvice Contributing Attorney

Answered 12 years ago | Contributor

I would make a photocopy of the repeated denials, and print out the emails.  Write a cover letter, with all of that, to customer service and send it certified mail, return receipt requested.  Tell them that this is their last chance to deal with you in good faith, and that if your claim is denied again you will take it up with an attorney and the Department of Insurance.

If they do deny your claim a fourth time, take all of the paperwork to a good lawyer.  One place to look for qualified attorneys in your area is our website, http://attorneypages.com

Annual mammograms are critical in the fight against breast cancer, because early detection saves lives.  Thank you for refusing to let the insurance company avoid its responsibility on this!


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