State Index to Web Sites of Consumer Health Assistance Programs That Help with Insurance Problems
CALIFORNIA:
- Department of Managed Health Care - (Government Agency) includes HMO Help Center. Web site includes information about the Department, notes from advisory board meetings, contacts for HMOs, information about the complaint and external appeals process, and an on-line complaint form. Some materials are available in Spanish and English.
- Health Consumer Alliance - (Nonprofit Agency) Provides services to low-income people through a network of legal services programs in six California counties. Web site includes consumer education materials in multiple languages, issue briefs, and reports. This program is privately funded.
- Health Rights Hotline - (Nonprofit Agency)
Serves all consumers in four California counties. Web site includes consumer education materials, reports that include data on consumer complaints, and an independent evaluation of the program. Web site includes materials in Spanish. This program is privately funded. - Office Of The Patient Advocate - (Government Agency) Web site includes information about the office, an HMO report card and a link to the managed care HMO Helpcenter.
CONNECTICUT:- Connecticut Insurance Department - (Government Agency) Web site of the Connecticut Insurance Department, which includes the Office of the Managed Care Ombudsman, established under Public Act 99-284. Web site includes consumer education materials and the text of the Act.
- Office of the Managed Care Ombudsman - (Government Agency) Established under Public Act 99-284. Web site includes consumer education materials, information regarding the appeals process, and the text of the Act.
FLORIDA:- Agency for Health Care Administration, Department of Health and Human Services - (Government Agency) Agency for Health Care Administration, Department of Health and Human Service, Florida. This page of the Agency for Health Care Administration's Web site explains the process for filing health care complaints and obtaining external reviews of HMO decisions. Volunteer managed care ombudsman committees function in some areas of the state.
GEORGIA:
ILLINOIS:- Health Care Bureau, IL Attorney General - (Government Agency) Health Care Bureau, Illinois Attorney General. Web site includes a description of services, examples of common health care complaints, and an on-line complaint form.
- Managed Care Helpline, Office of Managed Care, Department of Public Health - (Government Agency) Serves managed care consumers in Chicago. Web site includes information about the Office of Managed Care, statistics on calls to the Helpline, and the text of Chicago's Managed Care Consumer Protection Ordinance that established the Office.
- Office of Consumer Health Insurance/Ombudsman For The Uninsured - (Government Agency) Web site includes general information about the Managed Care Reform and Patients' Rights Act, consumer education materials, an annual report, complaint data, and an online complaint form.
KENTUCKYMAINE:MARYLAND:- Health Education and Advocacy Unit, MD Attorney General - (Government Agency) Web site includes information about services, a complaint form, and the Annual Report on the Health Insurance Carriers Appeal and Grievances Processes, which provides statistics on complaints filed with health insurers, the Insurance Administration, and the Health Education and Advocacy Unit.
MASSACHUSETTS:- Office Of Patient Protection - (Government Agency) Web site explains office's role, includes a guide to managed care, consumer rights brochure, health plan contact information, links to related agencies, and executive order establishing the office.
NEVADA:- Governor's Office for Consumer Health Assistance- (Government Agency) Web site includes text of the law establishing the Office, consumer education materials, an executive report with data on issues resolved by plan, money saved for consumers, and outreach activities, and an on-line complaint form. Information available in Spanish and English.
NEW JERSEY:- Community Health Law Project - (Nonprofit Agency) New Jersey Protection and Advocacy, Inc. - (Nonprofit Agency) These two independent, nonprofit programs are funded by the state to operate the program on an interim basis for one year. The Web sites describe each organization's services. Community Health Law Program's site includes publications on managed care, including one on consumer rights in both Spanish and English.
NEW MEXICO:- Managed Health Care Ombudsman Bureau - Website provides consumer information, newsletters and bulletins. Office provides consumer assistance with internal and external review mechanism.
NEW YORK:- Health Care Bureau, NY Attorney General- (Government Agency) Health Care Bureau, New York Attorney General. Web site includes consumer rights publications and referral to a toll-free consumer help line.
- Managed Care Community Assistance Project, New York City- (Nonprofit Agency) Serves all managed care consumers in New York City through a network of community organizations that is led by Community Service Society. Web site includes training materials on managed care and a library of studies, reports, and materials on managed care. Funded through the New York City Department of Health.
NORTH CAROLINA:- Office of Managed Care Patient Assistance, Managed Care Ombudsman, North Carolina Office of the Attorney General - (Government Agency) New consumer health assistance program established in May 2002. Web site not yet available.
OHIO:- Healthcare Helpline Story Bank - (Nonprofit Agency) Serves Toledo area and provides consumer assistance with insurance issues related to all types of health insurance and the uninsured. Phone: 419-242-3387 fax: 419-242-7404. Website not yet available.
PENNSYLVANIA:- Health Care Unit, Bureau of Consumer Protection - (Government Agency) Web site contains information about the Health Care Unit, patient rights, and complaint and appeal processes. Web site also provides an on-line Health Care Unit complaint form and summarizes other available complaint processes.
RHODE ISLAND:TEXAS:- Consumer Assistance Program for HMOs, TX Department of Insurance- (Government Agency) Includes the Consumer Assistance Program for HMOs, Texas Department of Insurance. Web site includes consumer brochures, limited summary data on complaints, and an on-line complaint form. The Department of Insurance currently operates the program directly, but under state law, may contract with a nonprofit organization to operate the program.
UTAH:VERMONT:- Vermont Legal Aid- (Nonprofit Agency) Vermont Legal Aid. Under state law, Vermont contracts with an independent nonprofit organization (currently Vermont Legal Aid) to provide health care ombudsman services. Web site currently only provides contact information. Call or write to the program for a copy of their annual report. Funded through the Vermont Banking, Insurance, Securities and Health Care Administration and by Vermont's Medicaid agency, the Office of Vermont Health Access.
VIRGINIA:* This list does not include programs that solely serve Medicaid or Medicare beneficiaries or programs that offer specialized assistance to, for example, mental health consumers. Insurance departments generally accept complaints regarding health insurance and have designated staff to investigate those complaints. Some administer external appeals processes regarding health plan decisions. We have listed here only those insurance departments that provide additional assistance to health insurance consumers. If you know of other programs that should be on this list, please e-mail cparcham@familiesusa.org.
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