We can help you with issues involving insurance companies and health plans and people we regulate. We don’t regulate most health plans or Medicare.
File a complaint with us if:
- Your insurance card has “TDI” or “DOI” on it. (See examples)
- You have a Medicare supplement policy.
- You have a long-term care insurance or disability plan.
- You have a short-term insurance and other limited benefit plans.
Not sure who regulates your health plan? Call our Help Line at 800-252-3439.
File a complaint through a different agency if:
We don’t regulate your health plan. Learn how by going to our webpage, How to file a complaint about a self-funded health plan.
Before you complain to us, understand that there are some things we can’t do:
- We can’t decide whether a treatment or service is medically necessary.
- We can’t force a company to pay a claim if the company didn’t violate the law.
- We can’t help with complaints about doctors, nurses, pharmacists, hospitals, and other health care providers. You must complain to the licensing or enforcement agency that regulates the provider.
File a complaint by using our online complaint system:
- Make a copy of the front of your insurance ID card.
- Go to our online complaint system.
- After answering some questions, you'll be asked if you want to upload supporting documents. Uploads are limited to 24 pages.
To help resolve your complaint, we need to share your information with the company or person your complaint is about. You must sign a consent form allowing us to share the information. If you don’t sign the consent form, we might not be able to help you. Some of the information you give us can be given to anyone who asks for it under the Texas Public Information Act. We will not give out confidential information. Medical records, financial information, and email addresses are confidential by law and will not be released.
Get help with a surprise bill
Patients get surprise medical bills if they get care outside their health plan’s network without realizing it. State and federal laws protect patients from surprise medical bills.
If you get a surprise bill for services between January 1, 2020, and December 31, 2021: The law bans balance bills in emergencies or when the patient didn’t have a choice of doctors for medical services.
If you get a surprise bill for services on or after January 1, 2022: The law bans balance bills in emergencies, when the patient didn’t have a choice of doctors for medical services, or for air ambulance services.
If you get a balance bill, visit our How to get help with a surprise medical bill webpage.
Have questions about the complaint process? Call us.
Call our Help Line at 800-252-3439 from 8 a.m. to 5 p.m. Central time.