Use the Appeal, Formal Complaint or Suggestion Form to send your comments to Aetna.
Get help from your state
Your state insurance office can help you if you don’t agree with a decision made by your health plan or if you decide to appeal a decision.
If you are not sure, ask your employer or call the toll-free number on the back of your medical plan ID card to find out which type of plan you have.
Get help from the federal government
The Health Care Reform law includes rules about appeals. Many plans have to follow these rules. If your plan is covered by the law*, you can contact the Employee Benefits Security Administration for help at 1-866-444-EBSA (3272).
Living outside the United States?
You may have a medical plan that covers you or your family while you’re living outside
the United States. If it's subject to the U.S. health care reform law, choose the state where the plan sponsor has its main place of business. Call the toll-free number on the back of your medical plan ID card if you're not sure.
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Alabama Department of Insurance (334) 241-4141 http://www.aldoi.gov/ |
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Alaska Division of Insurance (907) 269-7900 or 1-800- 467-8725 (In-state only) http://www.commerce.state.ak.us/insurance/ |
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Office of The Governor 011- (684) 633-4116 |
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Arizona Department of Insurance (602)364-2499 or 1-800-325-2548 (in Arizona but outside Phoenix) http://www.id.state.az.us/ |
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For Insured Plans Only Arkansas Insurance Department 1-800-852-5494 or (501) 371-2640 http://insurance.arkansas.gov/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Arkansas Insurance Department, Consumer Services Division 1200 West Third St. Little Rock, AR 72201 (855) 332-2227 Insurance.consumers@arkansas.gov * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only California Department of Insurance Consumer Hotline at 1-800-927-HELP http://www.insurance.ca.gov/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* California Consumer Assistance Program Operated by the California Department of Managed Health Care and Department of Insurance 980 9th Street, Suite #500 Sacramento, CA 95814 (888) 466-2219 http://www.HealthHelp.ca.gov * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only California Department of Managed Health Care 980 9th Street, Suite 500 Sacramento, CA 95814 (888) 466-2219 http://www.healthhelp.ca.gov helpline@dmhc.ca.gov |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* California Consumer Assistance Program Operated by the California Department of Managed Health Care and Department of Insurance 980 9th Street, Suite #500 Sacramento, CA 95814 (888) 466-2219 http://www.HealthHelp.ca.gov * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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California Processes
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Colorado Division of Insurance 1-800- 930-3745 - Toll Free http://www.dora.state.co.us/insurance/ |
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For Insured Plans Only Connecticut Department of Insurance 1-800-203-3447 or (860) 297-3900 http://www.ct.gov/cid/site/default.asp?ctportalPNavCtr=|27192|#45066 |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Connecticut Office of the Healthcare Advocate P.O. Box 1543 Hartford, CT 06144 (866) 466-4446 www.ct.gov/oha healthcare.advocate@ct.gov * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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Connecticut Processes
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For Insured Plans Only Delaware Insurance Department Call 1-800-282-8611 in Delaware or (302) 674-7310 http://delawareinsurance.gov/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Delaware Department of Insurance 841 Silver Lake Blvd Dover, DE 19904 (800) 282-8611 consumer@state.de.us * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only District of Columbia Department of Insurance, Securities and Banking (202) 727-8000 http://disr.dc.gov/disr/site/default.asp |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* DC Office of the Health Care Ombudsman and Bill of Rights 899 North Capitol Street, NE, 6th Floor, Room 6037 Washington, DC 20002 (877) 685-6391 healthcareombudsman@dc.gov * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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Florida Office of Insurance Regulation 1-877-693-5236 or (850) 413-3140 http://www.floir.com/ |
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For Insured Plans Only Georgia Office of Insurance and Safety Fire Commissioner (404) 656-2070 or (800) 656-2298 http://www.gainsurance.org/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Georgia Office of Insurance and Safety Fire Commissioner Consumer Services Division 2 Martin Luther King, Jr. Drive West Tower, Suite 716 Atlanta, Georgia 30334 (800) 656-2298 http://www.oci.ga.gov/ConsumerService/Home.aspx * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only Guam Department of Revenue and Taxation (671) 635-1817 https://www.guamtax.com/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Guam Department of Revenue and Taxation 1240 Army Drive Barrigada, Guam 96921 (671) 635-1844 * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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Hawaii Department of Commerce & Consumer Affairs Toll free numbers: Kauai 274-3141, extension 73222; Maui 984-2400; Big Island 974-4000; Molokai and Lanai 1-800-468-4644 http://hawaii.gov/dcca/ins/ |
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Idaho Department of Insurance In Boise and the surrounding area phone: (208) 334-4250 or Toll Free (in-state only) : 1-800-721-3272 http://www.doi.idaho.gov/ |
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For Insured Plans Only Illinois Department of Insurance Consumer Assistance Hotline toll-free number 866-445-5364 http://www.insurance.illinois.gov/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Illinois Department of Insurance 320 W. Washington St, 4th Floor Springfield, IL 62727 (877) 527-9431 http://www.insurance.illinois.gov DOI.Director@illinois.gov * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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Indiana Department of Insurance consumer hotline at 1-800-622-4461 http://www.in.gov/idoi/ |
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For Insured Plans Only Iowa Insurance Division (515) 281-5705 or Toll Free: 877-955-1212 http://www.iid.state.ia.us/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Iowa Consumer Advocate Bureau 330 Maple St Des Moines, IA 50319 (877) 955-1212 http://www.insuranceca.iowa.gov consumer.advocate@iid.iowa.gov * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only Kansas Insurance Department (785) 296-3071, Toll-free: 1-800-432-2484 (in Kansas only) http://www.ksinsurance.org/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Kansas Insurance Department Consumer Assistance Division 420 SW 9th Street Topeka, KS 66612 (800) 432-2484 (in state) 785-296-7829 (all others) http://www.ksinsurance.org CAP@ksinsurance.org * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only Kentucky Department of Insurance 1-800-595-6053 (option 1) or (502) 564-6034 http://insurance.ky.gov/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Kentucky Department of Insurance, Consumer Protection Division P.O. Box 517 Frankfort, KY 40602 (877) 587-7222 http://insurance.ky.gov DOI.CAPOmbudsman@ky.gov * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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Louisiana Department of Insurance 1-800- 259-5300 -or- (225) 342-5900 http://www.ldi.la.gov/ |
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For Insured Plans Only Maine Bureau of Insurance toll-free in Maine at 1-800-300-5000 or (207) 624-8475 http://www.maine.gov/pfr/insurance/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Consumer for Affordable Health Care 12 Church Street, PO Box 2490 Augusta, ME 04338-2490 (800) 965-7476 www.mainecahc.org consumerhealth@mainecahc.org * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only Maryland Insurance Administration (410) 468-2244 or 1-800-492-6116 http://www.mdinsurance.state.md.us/sa/jsp/Mia.jsp |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Maryland Office of the Attorney General Health Education and Advocacy Unit 200 St. Paul Place, 16th Floor Baltimore, MD 21202 (877) 261-8807 http://www.oag.state.md.us/Consumer/HEAU.htm heau@oag. state.md.us * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only Massachusetts Consumer Affairs & Business Regulation (617) 521-7794 or (877) 563-4467 (Toll Free) http://www.mass.gov/doi |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Massachusetts Consumer Assistance 30 Winter Street, Suite 1004 Boston, MA 02108 (888) 211-6168 www.massconsumerassistance.org * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only Michigan Department of Licensing and Regulatory Affairs 1-877-999-6442 http://www.michigan.gov/dleg/0,1607,7-154-10555---,00.html |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Michigan Health Insurance Consumer Assistance Program (HICAP) Michigan Office of Financial and Insurance Regulation P.O. Box 30220 Lansing, MI 48909 (877) 999-6442 http://michigan.gov/ofir ofir-hicap@michigan.gov * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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Minnesota Department of Commerce Insurance Gateway (651) 296-2488 or statewide toll free at 1-800-657-3602 http://www.state.mn.us/portal/mn/jsp/home.do?agency=Insurance |
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For Insured Plans Only Mississippi Department of Insurance 1-800-562-2957 or (601) 359-3569 http://www.mid.state.ms.us/ |
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For Insured Plans Only Missouri Department of Insurance, Financial Institutions & Professional Registration 1-800-726-7390 http://insurance.mo.gov/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Missouri Department of Insurance 301 W. High Street, Room 830 Harry S. Truman State Office Building Jefferson City, MO 65101 (800) 726-7390 www.insurance.mo.gov/ consumeraffairs@insurance.mo.gov * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only Montana Office of the Commissioner of Securities and Insurance (406) 444-2040 http://www.csi.mt.gov/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Montana Consumer Assistance Program 840 Helena Ave. Helena, MT 59601 (800) 332-6148 (in-state only) http://www.csi.mt.gov/ * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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Nebraska Department of Insurance (402) 471-2201 http://www.doi.ne.gov/ |
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For Insured Plans Only Nevada Division of Insurance Carson City - (775) 687-0700 or Las Vegas - (702) 486-4009 http://www.doi.nv.gov/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Office of the Governor, Consumer Health Assistance 555 East Washington Ave #4800 Las Vegas, NV 89101 (702) 486-3587 (888) 333-1597 http://www.govcha.state.nv.gov cha@govcha.state.nv.gov * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only New Hampshire Department of Insurance (603) 271-2261 Consumer Hotline 1-800-852-3416 http://www.nh.gov/insurance/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* New Hampshire Department of Insurance 21 South Fruit Street, Suite 14 Concord, NH 03301 (800) 852-3416 consumerservices@ins.nh.gov http://www.nh.gov/insurance/ * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only State of New Jersey Department of Banking & Insurance (609) 292-7272 or our Consumer Hotline 1-800-446-7467 http://www.state.nj.us/dobi/index.html |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* New Jersey Department of Banking and Insurance 20 West State Street, PO Box 329 Trenton, NJ 08625 (800) 446-7467 (888) 393-1062 (appeals) http://www.state.nj.us/dobi/consumer.htm ombudsman@dobi.state.nj.us * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only New Mexico Public Regulation Commission (505) 827-4548 or Toll Free 1-888-427-5772 http://www.nmprc.state.nm.us/id.htm |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* NM-PRC Insurance Division Health Insurance Consumer Assistance Program 1120 Paseo De Peralta Santa Fe, NM 87504 (855) 857-0972 or (888) 427-5772 (505) 476-0326 (fax) http://www.nmprc.state.nm.us/id.htm (website) mchb.grievance@state.nm.us (email) * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only New York State Department of Financial Services 1-800-342-3736, 212-480-6400, or (518) 474-6600 http://www.dfs.ny.gov/insurance/dfs_insurance.htm |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Community Service Society of New York, Community Health Advocates 105 East 22nd Street, 8th floor New York, NY 10010 (888) 614-5400 http://www.communityhealthadvocates.org/ cha@cssny.org * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only North Carolina Department of Insurance 1-800-546-5664 (In-state only) or (919) 807-6750 http://www.ncdoi.com/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Mailing Address North Carolina Department of Insurance Health Insurance Smart NC 1201 Mail Service Center Raleigh, NC 27699-1201 (877) 885-0231 http://www.ncdoi.com/Smart/ Delivery Service/Physical Address: North Carolina Department of Insurance Health Insurance Smart NC 430 N. Salisbury Street Raleigh, NC 27603 * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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North Dakota Insurance Department 1-800.247.0560 http://www.nd.gov/ndins/ |
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Ohio Department of Insurance consumer hotline at 1-800-686-1526 http://www.insurance.ohio.gov/Pages/default.aspx |
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For Insured Plans Only Oklahoma Insurance Department 1-800-522-0071 (in-state only) or (405) 521-2828 http://www.ok.gov/oid/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Oklahoma Insurance Department Five Corporate Plaza 3625 Northwest 56th Street, Suite 100 Oklahoma City, OK 73112 (800) 522-0071 (in-state only) (405) 521-2991 http://www.ok.gov/oid/Consumers/Consumer_Assistance/index.html * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only Oregon Insurance Division (503) 947-7984 or toll-free 1-888-877-4894 http://www.cbs.state.or.us/external/ins/index.html |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Oregon Health Connect 1435 NE 81st Ave. Suite 500 Portland, OR 97213-6759 (855) 999-3210 oregonhealthconnect.org healthconnect@211info.org * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only Pennsylvania Insurance Department Consumer Hotline: 1-877-881-6388 http://www.insurance.pa.gov/portal/server.pt/community/insurance_department/4679 |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Pennsylvania Department of Insurance 1209 Strawberry Square Harrisburg, PA 17111 (877) 881-6388 www.insurance.pa.gov * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only Puerto Rico Office of the Commissioner of Insurance (787) 304-8686 http://www.ocs.gobierno.pr/ocspr/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Puerto Rico Oficina de la Procuradora del Paciente 1215 Ponce de Leon PDA 18 Santurce, PR 00907 (800) 981-0031 www.pacientes.gobierno.pr querellas@opp.gobierno.pr * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only Rhode Island Department of Business Regulation (401) 462-9500 http://www.dbr.state.ri.us/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Rhode Island Consumer Assistance Program Rhode Island Parent Information Network, Inc. 1210 Pontiac Avenue Cranston, RI 02920 (855) 747-3224 www.RIREACH.org * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only South Carolina Department of Insurance (803) 737-6160 or 1-800-768-3467 http://doi.sc.gov/Pages/default.aspx |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* South Carolina Department of Insurance Consumer and Individual Licensing Services Division P.O. Box 100105 Columbia, SC 29202 (800) 768-3467 http://www.doi.sc.gov consumers@doi.sc.gov * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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South Dakota Division of Insurance (605) 773-3563 http://dlr.sd.gov/insurance/default.aspx |
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For Insured Plans Only Tennessee Department of Commerce and Insurance (615) 741-2241 http://www.state.tn.us/commerce/insurance/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Tennessee Department of Commerce and Insurance 500 James Robertson Pkwy Davy Crockett Tower, 4th floor Nashville, TN 37243-0574 (615) 741-2218 or (800) 342-4029 (615) 532-7389 (Fax) www.tn.gov/commerce/insurance/ * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only Texas Department of Insurance 1-800-578-4677 or (512) 463-6169 in Austin http://www.tdi.state.tx.us/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Texas Consumer Health Assistance Program Texas Department of Insurance Mail Code 111-1A 333 Guadalupe P.O. Box 149091 Austin, TX 78714 (855) 839-2427 (855-TEX-CHAP) www.texashealthoptions.com chap@tdi.state.tx.us * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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Utah Insurance Department Salt Lake City area: (801) 538-3800 or In-state toll-free: 1-800-439-3805 http://www.insurance.utah.gov/ |
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For Insured Plans Only Virgin Island Office of the Lieutenant Governor St. Thomas Complaints: (340) 774-7166 St. Croix Complaints: (340) 773-6459 http://ltg.gov.vi/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* U.S. Virgin Islands Division of Banking and Insurance 1131 King Street, Suite 101 Christiansted St. Croix, VI 00820 (340) 773-6459 http://ltg.gov.vi/ * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only Vermont Department of Financial Regulation at 1-800-631-7788 or (802) 828-3301 http://www.bishca.state.vt.us/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Vermont Legal Aid 264 North Winooski Ave. Burlington, VT 05402 (800) 917-7787 www.vtlegalaid.org * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only Virginia State Corporation Commission 1-877-310-6560 or (804) 371-9691 http://www.scc.virginia.gov/division/boi/index.htm |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Virginia State Corporation Commission Life & Health Division, Bureau of Insurance P.O. Box 1157 Richmond, VA 23218 (877) 310-6560 http://www.scc.virginia.gov/boi bureauofinsurance@scc.virginia.gov * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only Washington State Office of the Insurance Commissioner 1-800-562-6900 or (360) 725-7080 http://www.insurance.wa.gov/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* Washington Consumer Assistance Program 5000 Capitol Blvd Tumwater, WA 98501 (800) 562-6900 http://www.insurance.wa.gov/ cap@oic.wa.gov * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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For Insured Plans Only West Virginia Office of the Insurance Commissioner 1-888-TRY WVIC (888-879-9842) http://www.wvinsurance.gov/ |
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Additional Consumer Assistance for Plans Subject to Health Care Reform Law* West Virginia Office of the Insurance Commissioner Consumer Service Division P.O. Box 50540 Charleston, WV 25305 (888) 879-9842 http://www.wvinsurance.gov/ * This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010. This generally does not apply to:
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Wisconsin Office of the Commissioner of Insurance toll-free number at 1-800-236-8517 (within Wisconsin) or (608) 266-3585 (outside of Wisconsin) http://oci.wi.gov/ |
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Wyoming Insurance Department (307) 777-7401 or In-state toll free: 1-800-438-5768 http://insurance.state.wy.us/ |
Important information for members who reside in a state other than New York
Learn More
If you are a member who lives in a state other than New York, please see this important information.
* This generally applies to most Medical plans effective or renewed on or after September 23, 2010.
This generally does not apply to: