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Few industries are as regulated as health care.
That means that members of a health plan have specific rights that are regulated by federal, state, and, sometimes, local agencies. The HMO is required to give you a copy of your benefits, their exclusion policies, and their appeal procedures when you enroll. Any disputes and controversies may be addressed as an oral or written complaint to the Member Services Department. Every member has the right to file a written request for reconsideration when a request for a service is denied. Reconsideration requests must be filed within 1 to 2 months, depending on the HMO, from the date you are notified of a denial of benefits.