Virginia Health Information
 
Home > Health Insurance Options Guide

HIO For More Information

For More Information

In Virginia

Bureau of Insurance, State Corporation Commission-Licenses all health insurance companies, HMOs, and health services plans. The Consumer Services Section, Life and Health Division, assists Virginia consumers in resolving disputes with insurance companies, HMOs, health services plans, and the agents who may sell such insurance programs in Virginia. The bureau will also provide addresses and telephone numbers of insurance companies that are licensed to sell insurance in Virginia. www.scc.virginia.gov/division/boi

State Corporation Commission, Bureau of Insurance
Life and Health Division, Consumer Services Section
P.O. Box 1157
Richmond, VA 23218
Toll Free: 1-800-552-7945

Office of the Managed Care Ombudsman
Toll Free 1-877-310-6560
Local: 1-804-371-9032

Social Security Administration-Provides regional offices across Virginia. You may receive answers needed by phone or locate office nearest you. www.ssa.gov

Social Security Administration
1834 West Cary St.
Richmond, VA 23220
Local: 1-804-771-8125
Toll Free: 1-800-772-1213

Virginia Association of Health Plans-Represents Virginia's Managed Care Health Plans. Publishes the Directory of Virginia Health Maintenance Organizations, which includes profiles of Virginia HMOs. www.vahp.org

Virginia Association of Health Plans
1111 E. Main St., Ste 910
Richmond, VA 23219
Phone: 1-804-648-8466

Virginia Department for the Aging-Responsible for providing programs for those age 60 and older under the Federal older Americans Act. Provides counseling advocacy services under the Virginia Insurance Counseling and Advocacy Project. www.vda.virginia.gov

Virginia Department for the Aging
1610 Forest Avenue, Suite 100
Richmond, VA 23229
*In Richmond: 662-9333 (VTDD)
*Toll Free 1-800-552-3402 (VTDD)

For more information regarding the quality of health care services received at facilities licensed by the Virginia Department of Health's Office of Licensure and Certification ( http://www.vdh.state.va.us/OLC/contacts.htm) including hospitals, outpatient surgical hospitals, nursing facilities, home care organizations and hospice programs:

Virginia Department of Health
The Office of Licensure and Certification
9960 Mayland Dr., Suite 401
Richmond, VA 23233-1463
Toll Free: 1-800-955-1819
Local: 1-804-367-2106

Virginia Medicaid/DMAS-Administers Medicaid program for Virginia. http://dmasva.dmas.virginia.gov

Virginia Department of Medical Assistance Services
600 East Broad Street
Richmond, VA 23219
In Richmond: 786-7933
Toll Free: 1-800-552-8627


In Neighboring Areas

In Maryland

Maryland Insurance Administration-Licenses all insurers and agents; is involved in any activity necessary for regulation of insurance. Performs financial examinations, issues/revokes licenses, approves rates/forms; conducts hearings and investigations. Complaints and Investigation Unit/Life and Health Unit assists consumers in resolving disputes with health insurance companies. www.mdinsurance.state.md.us

Maryland Insurance Administration
Complaints and Investigation Unit/Life and Health
525 St. Paul Place
Baltimore, MD 21202
Toll Free: 1-800-492-6116

Social Security Administration-Provides regional offices across Maryland. You may get answers you need by phone or locate office nearest you. www.ssa.gov

Social Security Administration
5 Park Center Court, Suite 100
Ownings Mills, MD 21117
Phone: 1-410-965-8882
Toll Free: 1-800-772-1213

Health Services Cost Review Commission-Develops and carries out new health care policies including development of a comprehensive standard health benefit plan and quality and performance measures for HMOs. Publishes consumer HMO guide. www.mhcc.maryland.gov

Health Services Cost Review Commission
4160 Patterson Avenue
Baltimore, MD 21215
Phone: 1-410-764-2605
Toll Free: 1-877-245-1762

Health Choice and Maryland Children's Health Program-Health Choice is Maryland's statewide Managed Care Program for low-income citizens. Maryland Children's Health Program provides health insurance coverage for average to low-income children and pregnant women. http://dhmh.state.md.us

Health Choice
Maryland Department of Health and Mental Hygiene
201 West Preston Street
Baltimore, MD 21201
Phone: 1-410-767-6500
Toll Free: 1-877-463-3464

Medicaid Assistance-Provides health benefits for low-income people. Eligibility established through each local department of social services. http://dhmh.state.md.us

Medicaid/Maryland Department of Health and Mental Hygiene
201 West Preston Street
Baltimore, MD 21201-2399
In State Only/Toll Free: 1-800-685-5861
Phone: 1-410-767-6500
Public Information: 1-877-463-3464

Maryland Department of Aging-Oversees programs, services and benefits delivered through 19 local Area Agencies on Aging. Provides services directly to older persons or contracts with other agencies to administer programs. For more complete information on program availability and options, call your local Senior Information and Assistance Office or the number below to locate your office.www.mdoa.state.md.us

Maryland Department of Aging
301 West Preston Street, Suite 1007
Baltimore, MD 21201
*Toll Free: 1-800-AGE-DIAL (1-800-243-3425) In Maryland Only
*Phone: 1-410-767-1100

In North Carolina

North Carolina Department of Insurance-Consumer Services Division responds to questions and complaints concerning insurance; acquaints consumers with alternatives and courses of action that a citizen can pursue to solve a particular insurance problem. www.ncdoi.com

North Carolina Department of Insurance
1201 Mail Service Center
Raleigh, NC 27699-1201
Phone: 1-919-807-6750
Toll Free (in NC only): 1-800-JIM-LONG (1-800-546-5664)

North Carolina Association of Health Plans-A nonprofit trade association of health plans providing health care benefits; works to promote awareness/acceptance/growth of health plans in North Carolina. www.ncahp.org

N.C. Association of Health Plans, Inc.
PO BOX 10373
Raleigh, NC 27605
Phone: 1-919-271-2140

North Carolina Division of Aging-Provides system of services, opportunities, protective supports. Seniors' Health Insurance Information Program (SHIIP) provides information on Medicare, Medicare supplemental insurance and long-term care insurance; provides assistance/ counseling with health insurance problems.

North Carolina Division of Aging
2101 Mail Service Center
Raleigh, NC 27699-2101
*Phone: 1-919-733-3983
Seniors' Health Insurance
Information Program
*In State Only/Toll Free: 1-800-443-9354

North Carolina Division of Medical Assistance-Manages Health Check (Medicaid) program and NC Health Choice for Children (to age 18).

North Carolina Division of Medical Assistance
Office of Citizen Services www.dhhs.state.nc.us/dma/
Royster Building
1985 Umstead Drive
Raleigh, NC 27603-2001
Phone: 1-919-855-4401
Toll Free: 1-800-662-7030

In Tennessee

State of Tennessee/Department of Commerce & Insurance-Licenses health insurance companies and HMOs. Two consumer offices; one specifically to assist the elderly with health insurance/long term care (see below). The Consumer Services Office investigates consumer complaints concerning claims, agents and companies.

Consumer Services Office
500 James Robertson Parkway, Davey Crockett Tower
Nashville, Tennessee 37243-0565
Phone: 1-615-741-2241
In State Only Toll Free: 1-800-342-4029
or Insurance Assistance Office for the Elderly
In Nashville: 741-4955
*Toll Free: 1-800-525-2816

Tennessee Association of Health Maintenance Organizations- Association representing 18 Tennessee HMOs.

Tennessee Association of Health Maintenance Organizations
3100 West End Ave, Suite 600
Nashville, TN 37203-5801

TennCare Bureau-Services are offered through managed care organizations (MCOs) and behavioral health organizations (BHOs); is open to Medicaid-eligible or persons not insurable as determined by an insurance company's denial (for medical reasons) of health insurance.

TennCare Bureau
310 Great Circle Rd.
Nashville, TN 37243
Toll Free: 1-800-342-3145

In Washington D.C.

Department of Consumer and Regulatory Affairs, Business Regulation Administration-Ensures health, safety and economic welfare of D.C. residents through licensing, inspection, compliance and enforcement.

Insurance Department
810 1st Street NE, Suite 701
Washington, DC 20002
Phone: 1-202-727-8000

Social Security Administration-Provides regional offices in D.C. Receive answers by phone or locate office nearest you. www.ssa.gov

Social Security Administration
Postal Plaza Shipping Center
1905-B 9th St. NE
Washington, DC 20018
Toll Free: 1-800-772-1213

District of Columbia Office on Aging-Agencies provide information, assistance, outreach to seniors through network of programs. http://dcoa.dc.gov

District of Columbia Office on Aging
441 Fourth Street, NW
Suite 900-South
Washington, DC 20001
*Phone: 1-202-724-5622

Medicaid-Medicaid managed care plans; DC Healthy Families, a health insurance program for children and low-income families.

DC Medicaid Managed Care Help
122 C Street, NW #600
Washington, DC 20001
Phone: 1-202-639-4030

DC Medicaid
645 H Street, NE
Washington, DC 20002
Phone: 1-202-698-4220
Phone: 1-202-639-4030

In West Virginia

West Virginia Insurance Commission-Protects interests of policyholders in insurance matters; regulates all domestic and foreign insurance companies doing business in the state. Consumer Services serves as liaison between insurance industry and consumers not represented by attorneys. Consumer Advocacy serves public interest, regulates quality assurance for licensed HMOs. www.wvinsurance.gov

West Virginia Insurance Commission
Consumer Services Division
P.O. Box 50540
Charleston, WV 25305-0540
Phone: 1-304-558-3386

Consumer Advocate
P.O. Box 50540
Charleston, WV 25305-0540
Phone: 1-304-558-3864

West Virginia Bureau of Senior Services-Provides programs for senior citizens. West Virginia Senior Health Insurance Network (SHINE) provides health insurance counseling for Medicare beneficiaries.

Bureau of Senior Services
Holly Grove State Capitol
1900 Kanawha Blvd, East
Charleston, WV 25305
*Phone: 1-304-558-3317

West Virginia Senior Health
Insurance Network (WVSHINE)
Toll Free: 1-877-WV-SHINE
(1-877-987-4463)

Bureau of Medical Services-Provides access to appropriate health care for Medicaid-eligible individuals; administers Children's Health Insurance Program and Medicaid Managed Care Program.www.chip.wv.gov

WVCHIP Office
1018 Kanawha Blvd East, Suite 209
Charleston, WV 25301-3706
Local: 1-304-558-2732
Toll Free: 1-877-982-2447
Department of Health and Human Resources Client Services:
In State Only/Toll Free: 1-800-642-8589

Regional Tricare Information

Tricare-A program of health care coverages managed by the Department of Defense for active duty military personnel, their families, military retirees and their dependents. Tricare blends the military's direct care system, managed care providers and the original Champus program. The Tricare regional information phone and World Wide Web listings below indicate the states and areas covered by that listing.

For regional contact information please see www.tricare.mil/mybenefit


Nationally

Agency for Health Care Research and Quality-An arm of the U.S. Department of Health and Human Services (AHCPR). Develops practical, science-based information for medical practitioners, consumers and other health care purchasers. www.ahrq.gov

Agency for Health Care Research and Quality
540 Gaither Road
Rockville, MD 20850
Phone: 301-427-1364

National Association of Health Underwriters-A trade association of agents, brokers and consultants of insurance. www.nahu.org

National Association of Health Underwriters
2000 N. 14th Street, Suite 450
Arlington, VA 22201
Phone: 1-703-276-0220

National Committee for Quality Assurance-Since 1991, the NCQA has evaluated more than half of the nation's managed care programs in terms of patient records, complaints, equipment and personnel. NCQA may grant accreditation for three years, for one year, or provisionally or may deny accreditation. NCQA uses HEDIS to measure plan quality. www.ncqa.org

National Committee for Quality Assurance (NCQA)
1100 13th St., NW Suite 1000
Washington, DC 20005
Phone: 1-202-955-3500

Patient Advocate Foundation; National Patient Advocate Foundation-Provides educational materials to consumers on managed care; operates National Legal Services Network; works for health care reform. www.npaf.org

The National Patient Advocate Foundation
725 15th St. NW, 10th Floor
Washington, DC 20005
Toll Free: 1-800-532-5274
Phone: 1-202-347-8009

Social Security Administration-Provides regional and local offices. You may receive answers you need by phone or call to locate office nearest you.

Phone: 1-800-772-1213