Grievances & Complaints

pillsFile a grievance within your insurance company if:

  • You have a claim denial due to specific benefits exclusions or restrictions.
     
  • You want to file a formal complaint regarding any aspect of the services provided by your healthcare plan. 

As with the appeals processes, the process for filing a grievance will vary from health plan to health plan. Be sure to call your health plan's customer service department to obtain the specific details on how to file a grievance.

Tips for Communicating with Your Insurance Company

File a complaint with your state’s Department of Insurance if:

  • Your insurance company has denied you medical service(s) or treatment that is covered or that you feel should be covered in your plan.

How to File a Department of Insurance Complaint

 

 

 

Contact us with insurance questions, success stories, suggestions, or requests to volunteer.


PHA is proud to be able to make educational materials and programs like these available for free to everyone because of the generous support from members of the community just like you. Donations are welcome!

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Carol Morrison, PHA insurance volunteer


Carol Morrison, PHA insurance volunteer, uses her 15-plus years of experience in the insurance industry to help develop resources for the PH community.

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The National Organization for Rare Disorders (NORD) awarded PHA the Abbey S. Meyers Leadership Award in 2012 for outstanding service to PHA members in advocacy, education and other key areas.