Department of Insurance is Advocate for Consumers

Recent news stories have highlighted many health care coverage concerns for Idahoans. The
Idaho Department of Insurance is a valuable resource for information or help with questions about any
insurance product in Idaho.
As advocates for consumers, our Consumer Affairs officers received over 8,000 phone calls, investigated over
800 written complaints and recovered more than $2 million for Idahoans in 2008. Our highly trained staff can
help with questions such as:
 What insurance companies or insurance agents are licensed to sell insurance in Idaho?
We can confirm if a company or agent is licensed, provide complaint comparisons for previous years
and assist with coverage questions.
 My insurance company denied my claim. What do I do next? Can I file an appeal?
We can advise on appeal procedures or assist with a written complaint against an insurance company. In
January 2010 a new service will be available for consumers to request an independent external review of
medical claims that have been denied by insurers on the grounds that they are investigational or not
medically necessary.
 My new premium is 35% higher than what I was paying. Can the company charge me that much
more?
Written requests for assistance allow us to contact the insurance company and review the factors used
for a rate increase to see if that increase complies with Idaho insurance laws.
 I’ve been told I’m “uninsurable.” Is there any way I can get health insurance?
The Idaho Individual High Risk Reinsurance Pool Plans may provide coverage for residents who are
“uninsurable.” We can explain eligibility, benefit options and coverage under the five available plans,
and the amount of monthly premium for each plan.
 I have questions and need information about Medicare.
Our Senior Health Insurance Benefits Advisors (SHIBA) are always happy to assist you with your
Medicare concerns. Call them toll-free at 800-247-4422.