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Health Insurance Consumer Protections

What is health insurance? 

No one plans to get sick or injured, but health insurance provides critical financial protection when you do. Using health insurance to receive regular check-ups and preventive care can also help prevent or manage serious illnesses. Health insurance is an important part of taking care of your health and protecting yourself from expensive medical bills. 

What is the Commerce Department’s role? 

The Minnesota Department of Commerce’s Insurance Division regulates insurance in the state, including health insurance. The health insurance area reviews and approves many of the health plans insurance companies would like to sell in Minnesota, as well as the rates they would like to charge. The Enforcement Division responds to consumer inquiries, investigates complaints, and facilitates external reviews to ensure that Minnesotans receive the coverage that they pay for.  

Commerce can help you with issues involving insurance companies and the health plans we regulate. We don’t regulate all health plans

Was your insurance claim denied? 

If you are denied coverage for an insurance claim or prior authorization request, first contact your health plan at the phone number on the back of your insurance card. Health plans provide a way for you to file an internal appeal with the insurance company. If the decision is not reversed or you remain dissatisfied, you have the right to an external review facilitated by the Commerce Department. You must file an external review within six months of your claim being denied

Note that your health plan cannot reduce or stop coverage for ongoing treatment during an internal appeal or external review. If you have questions about your rights during this process, contact the Commerce Department’s Consumer Services Center at 651-539-1600 or (800) 657-3602. Questions can also be sent by email to consumer.protection@state.mn.us

File an external review

Need to file a complaint against a health care provider or facility? 

If you need to file a complaint against a doctor, nurse, dentist, pharmacist, or hospital, you can reach out to organizations that regulate these groups or the Minnesota Department of Health

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