Take the Proper Steps Before Filing a Complaint

If your health plan is a “managed care plan”, you may have certain rights under Act 68.

Please Read Carefully
Filing a complaint with the Attorney General may not preserve your appeal rights, pursuant to ACT 68 or Medicare. To preserve your rights, you must file a complaint or grievance appeal directly with your health plan or in conformance with the terms of your coverage. The Office of Attorney General does not give legal advice.

If you have a problem with your insurance plan, you should “Take the Proper Steps”, as follows:

1. Call your plan’s member services department. Always call your plan’s member services department first. Give them a chance to solve the problem. Many problems are solved at this level in an informal manner.
2. File a formal complaint or grievance with your plan. If your phone call to the plan does not solve your problem, call the plan again and tell them that you want to file either a formal complaint or a formal grievance.
3. File a complaint with the Attorney General’s Health Care Section by:  Calling – 1-877-888-4877, mailing in a PDF or submitting an ONLINE Complaint.