Dear Myra:  Insurance companies are not that complicated.  They’re businesses driven by financial decisions not emotional ones.  When we are in the throes of caregiving, our emotions run high and often unchecked.  When getting on the phone with an insurance representative, remember that they have a job to do.  You may not like it, and they may indeed by calloused, cold, or seem uncaring.  But you don’t need them to emote with you, you need them to help facilitate payment of a service, drug, or equipment.  If you must appeal, demonstrate the appeal is in their best financial interest.  Every appeal I’ve won, we did so because it made financial sense for the insurance company. Mostly, because granting the appeal kept my wife out of the hospital.  Also, many insurance companies offer a service that assigns a case manager, usually a nurse, to patients with lengthy and extensive medical needs. Ask for such a manager, they will become a great ally to you and your loved one.