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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
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
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
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
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
Virginia Medicaid/DMAS-Administers Medicaid program for Virginia. http://dmasva.dmas.virginia.gov
Virginia Department of Medical Assistance Services
In Neighboring Areas
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
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
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
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
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
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
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
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.
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
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
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
Tennessee Association of Health Maintenance Organizations- Association representing 18 Tennessee HMOs.
Tennessee Association of Health Maintenance Organizations
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.
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.
Social Security Administration-Provides regional offices in D.C. Receive answers by phone or locate office nearest you. www.ssa.gov
Social Security Administration
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
Medicaid-Medicaid managed care plans; DC Healthy Families, a health insurance program for children and low-income families.
DC Medicaid Managed Care Help
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
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
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
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
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
National Association of Health Underwriters-A trade association of agents, brokers and consultants of insurance. www.nahu.org
National Association of Health Underwriters
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)
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
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
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