STEP ONE – Notify Your Health Plan

The first thing you need to do is file a complaint with your health plan. By Massachusetts law, complaints must be resolved within 30 days. Follow the steps below to file a complaint and grievance with your health plan:

  • The law requires health plans accept your complaint by phone, mail, in person or electronically (by fax or e-mail).
  • Tell them you want to file a formal complaint and then explain the problem.
  • If you disagree with your health plan’s decision, you have the right to file a grievance.
  • Find more information on Massachusetts health plans’ grievance processes here.

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

STEP TWO – File a Complaint

You have the right to file a complaint with the Massachusetts Office of Patient Protection (OPP) 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 grievance process.

  • File a complaint with the OPP using the external review request form here.
  • Call the OPP by phone: (800) 436-7757.
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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.