Where your appeal goes, and who to complain to
Two facts that are federally published, so they can be checked: which external review process covers you, and which department regulates your insurer. What your state requires plans to COVER is not here — that is state law, and this site does not publish state-law claims it cannot verify against the source.
Read this first. The HHS-administered Federal External Review Process was down for most of July 2026 and reopened on 31 July, per CMS. If your deadline to request external review fell between 1 July and 3 August 2026, you have until 2 OCTOBER 2026 to file with MAXIMUS, the contractor that runs it. If you filed before 1 July and are still waiting, CMS says you do not need to resubmit. Ask your plan in writing whether it uses the federal process, because being in one of these places is not enough on its own.
| Where you are | Who runs external review | Your insurance department |
|---|---|---|
| Alabama | The federal processHHS-administered, or an independent review organisation your plan contracts with. Currently disrupted — see above. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| Alaska | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| American Samoa | The federal processHHS-administered, or an independent review organisation your plan contracts with. Currently disrupted — see above. | Contact detailsNo online complaint portal is published for this jurisdiction. Use the contact details above. |
| Arizona | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| Arkansas | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsThe complaint link on file was dead when checked. Use the contact details above. |
| California | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Colorado | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| Connecticut | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Delaware | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| District of Columbia | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Florida | The federal processHHS-administered, or an independent review organisation your plan contracts with. Currently disrupted — see above. | Contact detailsFile a complaint |
| Georgia | The federal processHHS-administered, or an independent review organisation your plan contracts with. Currently disrupted — see above. | Contact detailsFile a complaint |
| Guam | The federal processHHS-administered, or an independent review organisation your plan contracts with. Currently disrupted — see above. | Contact detailsNo online complaint portal is published for this jurisdiction. Use the contact details above. |
| Hawaii | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| Idaho | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Illinois | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| Indiana | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Iowa | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Kansas | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| Kentucky | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Louisiana | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| Maine | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Maryland | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| Massachusetts | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| Michigan | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Minnesota | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Mississippi | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsThe complaint link on file was dead when checked. Use the contact details above. |
| Missouri | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| Montana | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Nebraska | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Nevada | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| New Hampshire | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| New Jersey | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| New Mexico | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| New York | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| North Carolina | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| North Dakota | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Northern Mariana Islands | The federal processHHS-administered, or an independent review organisation your plan contracts with. Currently disrupted — see above. | Contact detailsNo online complaint portal is published for this jurisdiction. Use the contact details above. |
| Ohio | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Oklahoma | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| Oregon | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Pennsylvania | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Puerto Rico | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Rhode Island | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| South Carolina | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| South Dakota | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Tennessee | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Texas | The federal processHHS-administered, or an independent review organisation your plan contracts with. Currently disrupted — see above. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| Utah | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Vermont | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Virgin Islands | The federal processHHS-administered, or an independent review organisation your plan contracts with. Currently disrupted — see above. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| Virginia | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| Washington | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| West Virginia | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsFile a complaint |
| Wisconsin | The federal processHHS-administered, or an independent review organisation your plan contracts with. Currently disrupted — see above. | Contact detailsFile a complaintLink listed by NAIC; this site could not load it to check, because the site blocks automated requests. |
| Wyoming | Your stateIt runs a process meeting or exceeding the federal standard. | Contact detailsThe complaint link on file was dead when checked. Use the contact details above. |
External review routes from CMS, insurance department links from the NAIC directory, both read on 2026-08-14. None of this reaches a self-funded employer plan — a state insurance department has no authority over one, whatever your card says.
Better covered elsewhere
- Movement Advancement Project — state bans on care for transgender youth
A different question from coverage: whether the care is lawful for under-18s where you live, not whether a plan pays for it. Covers every state, DC and the territories, and marks separately the bans that are on the books but not currently in effect — a distinction most reporting on this drops.
Last updated 2026-08-15 · Not legal or medical advice