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How to File an Insurance Complaint with ODI
by Judith L. French, Director
Insurance is complex, and at the Ohio Department of Insurance we are here to help consumers sort it all out.
Every year, we assist thousands of Ohioans with their insurance concerns, providing educational resources, answering questions, and investigating complaints.
Through these efforts, we save consumers millions of dollars annually by resolving disputes over coverage, claims, benefits, and services as well as by identifying financial assistance programs.
Ohio law gives important rights to insurance consumers, including the right to make an insurance complaint to the Ohio Department of Insurance for investigation. Our services are free and unbiased and we are committed to ensuring fair treatment for all Ohioans.
If you have questions about an insurance situation or topic, such as pertaining to automobile, homeowners, life, health, and mental health insurance call 800-686-1526, and for Medicare-related help, 800-686-1578. We also encourage you to engage with licensed insurance agents for support.
Please reach out to us and also visit insurance.ohio.gov for insurance information.
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Health Insurance: What Is Prior Authorization?
While receiving medical care or picking up a prescription, individuals may encounter a process known as prior authorization. This process requires medical providers to obtain approval from the patient's health insurance plan before delivering health care services or prescribing medications.
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Determining Mental Health Insurance Benefits in a Health Plan
Understanding the type of health insurance plan is essential for determining the mental health and substance use disorder benefits it offers. Here’s how to find out!
- Check the certificate of coverage issued by the insurer or provided by the employer
- Contact the employer's human resources office
- Contact the insurer (there should be a telephone number on the back of the insurance card)
- Contact the insurance agent who sold the policy
Ohio Department of Insurance representatives are available at 800-686-1526 to answer any questions. Also, helpful information is available in this Understand Your Coverage tip sheet!
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Medicare Enrollment Opportunities Getting Underway
Medicare's annual open enrollment period concluded on Dec. 7, but other enrollment opportunities for Medicare coverage are getting underway.
Ohioans on Medicare who did not sign up for Part A (hospital insurance) and/or Part B (medical insurance) during their initial enrollment period, and do not qualify for a special enrollment period, can sign up for Medicare during the Jan. 1 to March 31 general enrollment period. Coverage begins on the first day of the month after signing up.
The Medicare Advantage open enrollment period also runs from Jan. 1 to March 31. During this time, individuals in a Medicare Advantage plan can switch to another Medicare Advantage plan or return to Original Medicare. For Ohioans impacted by network disruptions with Medicare Advantage plans, this enrollment period is another opportunity for Medicare Advantage plan enrollees to review their provider networks and determine if their current plan is adequate or if another plan (or Original Medicare) would be a better alternative. Any changes made during this period will take effect on the first day of the month after the new plan receives the request.
Additionally, starting Jan. 1, two new special enrollment periods are available. One is for individuals who are eligible for both Medicare and Medicaid, and the other is for those who qualify for Extra Help, a low-income subsidy for prescription drug costs.
Get more information here!
Staff from the Ohio Senior Health Insurance Information Program are available at 800-686-1578 and oshiipmail@insurance.ohio.gov to answer any questions.
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Attention Insurers: Ohio Premium Tax and Other Filings Required in 2025
The Ohio Department of Insurance prioritizes implementing efficiencies into its regulatory requirement processes for insurance companies. Many of the filings, including tax returns, required of insurers authorized to transact business in the State of Ohio are now paperless and must only be filed electronically.
The Office of Risk Assessment has posted calendar year 2024 forms to be filed in 2025 and has listed the filing requirements in "Checklist" documents, organized by company type. The Checklists give guidance for annual, quarterly, and interim filings and are available on the Ohio Department of Insurance website.
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Agent/Agency Annual Title Filing Reviews for 2024 Due Jan. 15
Licensed Ohio title agents and agencies or their authorized representatives are required to file an annual title agent/agency review with the Ohio Department of Insurance through the OH|ID system.
The annual filings for the 2024 filing period (Sept. 1, 2023 to Aug. 31, 2024) are due by Jan. 15, 2025.
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The 988 Lifeline provides 24/7, free, and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals in the United States. Text 988 or CHAT WITH THE 988 LIFELINE.
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