Hawaii

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 information and complaint forms for Hawaii’s top health plans:

• Cigna
• IHC Group
• Hawaii Medical Assurance Association
• Kaiser Permanente
• Medicaid Plans
• UnitedHealthcare
  • Log on to MyUHC.com 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 instructionsUnitedHealthcare
• My plan isn’t listed
• Medicare Plans

STEP TWO – File a Complaint

You have the right to file a complaint with the Hawaii Department of Commerce and Consumer Affairs – 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 out how to file a consumer complaint or appeal with the Hawaii Department of Commerce and Consumer Affairs – Insurance here.

You can also call the Hawaii DCCAI’s helpline at (808) 586-2790.