Many Americans are covered under an employer's health benefit plan. These plans typically have an appeal process if your medical benefits were denied. After your appeal, you can file a lawsuit against the insurance company. Most plans give you at least two years to sue, but if you are covered under Walmart's health benefit plan, you only have 180 days to sue if the plan denies your claim on appeal.
Walmart's health benefits plan may deny your applied behavioral analysis (ABA therapy) for many reasons. The most common denial we see is the plan not covering treatment for a "learning an educational disorder." The plans we have reviewed have gone on to say that Walmart does not cover "educational training/testing or Behavior Modification due to nervous, mental, or emotional disorders." Walmart's independent medical advisors AND its legal team have told Walmart that ABA therapy is not supported by the terms of Walmart's health benefit (insurance) plan.
This notice is only to alert you to the very, very short time frame for suing the Walmart health benefit plan (180 days) and to offer some level of assistance to families who might be fighting Walmart on this issue.
A court certified a class action lawsuit against Cigna on its denial of ABA therapy under its health benefits plan.
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