STEP ONE – Notify Your Health Plan

The first thing you need to do is file a complaint with your health plan. Follow the steps below to file a complaint and appeal with your health plan:

  • Call the member/customer service phone number for your health plan.
  • Tell them you want to file a formal complaint and then explain the problem.
  • You can also file your complaint by letter, email, or online through your health plan’s website (see below).
  • If you disagree with your health plan’s decision, you have the right to file an appeal.

Below are links to the complaint forms and information for top health plans in Delaware:

  • Aetna
  • Highmark Blue Cross Blue Shield
    • Log into your member account to access more information on filing an appeal
  • UnitedHealthcare
    • Log on to and complete the “Appeals and Grievance Form”
    • Select: Claims and Accounts > Medical Appeals and Grievances > Member Service Request Form
    • Fax or mail the completed form to the UnitedHealthcare address listed in the instructions
  • Medicare Plans
  • My plan isn’t listed

STEP TWO – File a Complaint

You have the right to file a complaint with the Delaware Department of Insurance if you have a problem getting the services you need, including quality and affordable health care. To file a complaint, you must first complete your health plan’s appeal process.

You can find information on how to file a consumer grievance or appeal with the Delaware Department of Insurance here.

You can also call the Delaware DOI Hotline at (800) 282-8611 (within Delaware) or (302) 674-7310.

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Know Your Rights

State and federal law protects your rights. When you sign up for a health plan and/or if you have problems accessing care through your health plan, it is important to know your rights.