Denied by CareFirst BlueCross BlueShield, Kaiser Permanente Mid-Atlantic, Aetna, UnitedHealthcare, or Cigna? Maryland gives you binding external review and free assistance through the Attorney General. ClaimBack writes your appeal in 3 minutes.
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Maryland provides strong consumer protections through the Maryland Insurance Administration, binding external review by independent medical experts, free advocacy through the Attorney General, and clear notification requirements for insurers.
The MIA regulates all insurance companies in Maryland and has authority to order insurers to reverse improper denials. In 2025, MIA recovered over $70 million for Maryland consumers through complaint investigations. When an insurer denies coverage, Maryland law requires the denial letter to prominently display appeal information in bold type at the top, ensuring you know your rights immediately. MIA must complete complaint investigations within 45 days.
Under Maryland's Health Care Appeals & Grievance Law, after exhausting internal grievance, you can request external review through MIA within 120 days of the denial. An independent medical expert — with no ties to your insurer — determines if the recommended treatment is medically necessary. The Insurance Commissioner has the authority to overturn your health plan's decision. Standard review takes up to 60 days; expedited review takes no longer than 4 business days.
Internal grievance: file within 180 calendar days of the adverse decision. Response times: 30 business days for pending treatment, 45 business days for treatment already received, 24 hours for emergencies. External review: submit within 120 days of denial. Standard external review: up to 60 days. Expedited external review: 4 business days. MIA complaint investigations must be completed within 45 days of receipt.
The Attorney General's Health Education and Advocacy Unit (HEAU) provides free assistance with appeals — call 410-528-1840 (Mon-Fri, 10 AM-2 PM) or visit MarylandCares.org. Maryland mandates mental health parity under MD Insurance Article §15-802 and autism coverage under §15-835 with no age cap. Denial letters must display appeal rights in bold type. Reports show appeals are often successful when filed, yet the vast majority of denied claimants never appeal.
Three steps. No jargon. No legal degree required.
In Maryland, first file an internal grievance with your insurer within 180 calendar days of the adverse decision. Your insurer must respond within 30 business days for pending treatment or 45 business days for treatment already received. In emergency cases, a decision must be provided within 24 hours. If denied again, you can request external review through the Maryland Insurance Administration (MIA) within 120 days. An independent medical expert will review your case.
The Maryland Insurance Administration (MIA) is the state agency that regulates insurance companies in Maryland. MIA handles consumer complaints, enforces insurance laws, and administers the external review process for health insurance denials. In 2025, MIA recovered over $70 million for Maryland consumers through complaint investigations. The Insurance Commissioner has the authority to overturn your health plan's decision to deny a claim if the treatment is determined to be medically necessary.
After your insurer upholds its denial through the internal grievance process, you can submit a request for external review to the MIA within 120 days. An independent medical expert — with no ties to your insurer — reviews your case to determine if the recommended treatment is medically necessary. Standard external review takes up to 60 days. Expedited external review for urgent cases takes no longer than 4 business days. Maryland law requires denial letters to display appeal information in bold type.
The Maryland Attorney General's Health Education and Advocacy Unit (HEAU) provides free assistance with filing insurance appeals and complaints. You can call their hotline Monday to Friday, 10 AM to 2 PM, at 410-528-1840 (Spanish: 410-230-1712) or file online at MarylandCares.org. Maryland law also requires insurers to print appeal information prominently in bold type at the top of denial letters, ensuring you know your rights immediately.
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