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Employer Health Plan Denials

Meaning

Employer Health Plan Denials refer to the formal refusal by a health insurance plan, particularly one administered through an employer, to cover the cost of a specific medical service, medication, or diagnostic test. These denials are typically communicated in writing and state that the requested care is either not deemed medically necessary, is considered experimental, or is explicitly excluded under the policy’s terms. For hormonal treatments, denials often revolve around the use of therapy for age-related decline versus diagnosed pathology.