What type of coverage may not provide appeal rights for claims?

Presumptive eligibility determinations refer to the temporary eligibility status granted to individuals when they apply for health coverage, allowing them to access medical services while their eligibility is being finalized. This coverage is often used to ensure that individuals can receive care right away, particularly during urgent situations. However, because it is a preliminary status rather than a final determination of eligibility, it typically does not carry the same rights for appeals as standard insurance coverage once eligibility is confirmed.

In contrast, emergency medical services, standard in-network services, and out-of-network services generally come with established appeal rights based on the terms of a person's health insurance policy. These services are part of ongoing, recognized coverage plans where policies outline specific rights to appeal decisions regarding denial of claims.