Texas community resource
Health Plan Appeal and External Review Help
Texas Department of Insurance
Consumer guidance and help with health-plan treatment appeals, independent external review, and related insurance complaints.
Information last checked:
How to get help
First follow the appeal instructions in the denial notice and plan booklet. If eligible, request external review after an unfavorable appeal or qualifying life-threatening denial. Call TDI if unsure what type of plan applies or which regulator can help.
Who this service helps
People whose health plan denied treatment, a procedure, or medicine. TDI can help with fully insured plans; other plan types may be overseen by federal agencies or another program.
Where this service is available
Service area: Consumers with health coverage in Texas, including residents of the Central Texas counties; TDI assistance applies to fully insured plans within its authority.
A service area describes where help is offered or who may be served. It is not necessarily the organization’s physical location.
Cost / fees
External reviews are free to the consumer.
About this service
TDI explains how to appeal a plan's denial of treatment, procedure, or medicine and how to request a free external review after an appeal or for denied care involving a life-threatening condition.
Other resources that may help
Before you contact this provider
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