Agencies that Oversee Health Plans
If you have a problem or complaint about your health plan, you can contact the agency that oversees or regulates the plan. Ask the agency how to file an external appeal.
HMOs and some Anthem Blue Cross/Blue Shield PPOs
Indemnity or fee-for-service plans and many PPOs
Self-insured (or self-funded) plans
- The federal government (Centers for Medicare and Medicaid Services) oversees Medicare. The Medicare Beneficiary Ombudsman can provide information about how to file a complaint or appeal.
- For help with Medicare, contact HICAP at 1-800-434-0222.
- Find more information on Medicare complaints.
If you do not know where to go for help
It can be hard to figure out who oversees your health plan. If you aren't sure where to go for help, you can call the California Consumer Assistance Program toll-free at 1-888-466-2219 to find out the best course of action for you.