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Health Insurance

    Health Insurance

    No Surprises Act

    Starting in 2022, a new federal law, The No Surpises Act, will protect you from many types of "surprise" medical bills. For more info or to file a complaint: CMS.gov/nosurprises

    MDH frequently asked questions

    What you need to know about appeals

    • During the internal and external appeals process, your health plan can’t reduce or stop coverage for ongoing treatment.
    • You have six months from the day of your last claim denial to file an appeal for both external and internal review.
    • Contact your health plan for details on its internal review process.

    The Minnesota Department of Commerce regulates the insurance industry to protect consumers and ensure a fair and competitive marketplace. Commerce investigates complaints on behalf of consumers and works to resolve disputes between consumers and insurers.

    Commerce is here to help

    Health insurance is complex and difficult to navigate for even the most savvy consumer. You will find in this section basic information on buying health insurance and making the most of your coverage.

    Learn more about Minnesota's rate review process and explore Medicare options.

    Making a complaint

    If you have a health insurance claim that has been denied by your health plan, you have the right to appeal that denial. The first thing you should do is contact your health plan and ask for more information on why the claim was denied. This is the first step in the internal appeals process and insurance companies are required to address your complaint within a strict timeline.

    If you are still are not satisfied with the health plans's denial of your claim you may be able to request an external review. Review your summary of benefits on the appeals process. 

    For the external appeals process, Commerce will work with an impartial third party to determine if the denial was justified. The health plan must follow the decision. However, if you are not satisfied with the result of the decision you have the right to appeal the decision in court.

    File an External Appeal

    Memorandum to Health Insurance Carriers Related to Coronavirus

    The Department has released a letter to health insurers requesting they take certain measures to remove financial barriers to COVID-19 and assist with the public health effort to limit the impact of the disease.

    Property and Casualty, Memorandum to Insurers Doing Business in Minnesota (.pdf) April 27,2020

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