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:

  • Contact your health plan and document all phone calls and written communications.
  • Your health plan must respond to your initial complaint within 21 days.
  • To file an appeal, contact the Department of Insurance for assistance: (866) 445-5364.

Below are links to the complaint forms for Illinois’ top health plans:

Medicare Plans

STEP TWO – File a Complaint

You have the right to file a complaint with the Illinois Department of Insurance (DOI) if you have a problem getting the services you need, including quality and affordable health care. File a complaint with the DOI after documenting your complaint process with your health plan. The DOI only accepts complaints submitted in writing.

  • File a complaint online here or by contacting the DOI here.
  • When the DOI receives your complaint, it will assign you a file number and will send you written notification of that number.
  • DOI will respond to your complaint explaining the results of their decision within 6 weeks
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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.