Maryland

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 (see below).
• Contact the Maryland Attorney General’s Health Care Education and Advocacy Unit for help in filing your appeal: (877) 261-8807.

Below are links to the complaint forms of Maryland‘s top health plans:

• CareFirst Blue Choice (HMO)
• CareFirst Blue Cross Blue Shield
• Cigna
• Kaiser Permanente
• My plan isn’t listed

Medicare Plans

 

STEP TWO – File a Complaint

You have the right to file a complaint with the Maryland Insurance Administration (MIA) if you have a problem getting the services you need, including quality and affordable health care. You must complete your health plan’s appeal process before you can file a complaint with the MIA.

• You must file a written complaint, including a signed consent form, within four months after receiving your health plan’s decision.
• Provide copies of all documentation relevant to your case.
• Download the complaint form here and mail to the MIA address below or fax: (410) 468-2260.
• Find more information on submitting a written complaint here.
• Call the MIA helpline: (800) 492-6116.

Maryland Insurance Administration
Attn: Consumer Complaint Investigation re: Health Insurance
200 St. Paul Place, Suite 2700
Baltimore, MD 21202