What is the Consumer Assistance
The Commissioner serves as Montana's health insurance ombudsman, helping consumers file complaints and appeals, assisting consumers with enrollment into health coverage, and educating consumers about their rights and responsibilities. If you have questions about health insurance, call the Commissioner's office at 1-800-332-6148 or send an email to firstname.lastname@example.org
The Commissioner's office has also created a new consumer's guide to health insurance that explains current rights and protections. Click here to download the consumer's guide to health insurance.
The Consumer Assistance Program is made of three core efforts:
- On-location Outreach: The Commissioner's office holds office hours and consumer education forums in towns across Montana.
- Public Service Announcements: The Commissioner's office produced two public service announcements that aired across the state to publicize the office's resources for consumers. Watch the public service announcements on the CSI YouTube channel:
Here to Protect You – PSA #1
Here to Protect You – PSA #2
- Medical Provider Training: The Commissioner hosts trainings for doctors, nurses, and other medical professionals on changes to insurance rules and regulations. These trainings are held in tandem with on-location outreach.
Why does Montana need a Consumer Assistance Program?
There are many new insurance market reforms aimed at protecting consumers, making health insurance more transparent, and increasing access to coverage. The Consumer Assistance Program is designed to educate Montanans about their rights and protections, including:
- Essential Market Reforms, like ensuring children's preexisting conditions are covered, allowing parents to keep their children insured under their policy until age 26, and barring lifetime and annual caps on coverage.
- An External Review Process that allows Montanans to request an independent medical professional's review of an insurer's decision to deny their claim. Click here to download the consumer's guide to internal appeals and external review.
Help with understanding your health insurance plan:
Montanans have a new tool to help with understanding their health insurance plans. Private insurers are now required to provide consumers with a Summary of Benefits and Coverage (SBC) — which is a simple explanation of what a policy covers, written in plain language.
The new regulation is designed to help consumers better understand and evaluate health insurance choices. Insurance issuers and group health plans are also required to include a uniform glossary of terms commonly used in health insurance coverage, such as "deductible" and "copayment." Find more information on the SBC and Uniform Glossary with the links at the right.