Consumer Assistance Program

Many states offer help to consumers with health insurance problems. The Affordable Care Act improves these services with grants that help states start or strengthen Consumer Assistance Programs (CAPs). The map below provides information on resources available to consumers, including states that have received funds through the Consumer Assistance Program grants.

Get Help with a Problem or Question

Whether or not your state has a Consumer Assistance Program, you have rights under the health care law, including the right to appeal decisions made by your health insurance provider.

If your state does not have a Consumer Assistance Program, you still have options to help you determine your rights and solve problems. Visit the map to find resources and contact information that may provide this help. Get phone numbers, email addresses, and other contact information.

Find consumer assistance in your state

If you are a participant or beneficiary in an employer-sponsored health plan contact the Employee Benefits Security Administration, U.S. Department of Labor at www.askebsa.dol.gov or call 1-866-444-3272.

What This Means for You

Before the health care law, you often had to fend for yourself when trying to find affordable health insurance or resolve problems with a health plan, such as when your insurer denies a claim or refuses to pay for needed treatment. Even though some states have had programs to help consumers, those programs often have been overburdened and underfunded.

Now, federal grants are helping states and territories build Consumer Assistance Programs that offer more hands-on assistance to more people. These programs can help you:

•   File complaints and appeals.
•   Enroll in health coverage.
•   Get educated about your rights and responsibilities.

These programs also collect data on the types of problems consumers are having. They will file reports with the Secretary of the U.S. Department of Health and Human Services to identify trouble spots that may need further oversight.

Consumer Assistance Programs Get Results

Evidence shows that hands-on consumer assistance programs resolve complaints and appeals effectively. During the first year of the grant period, Consumer Assistance Program grantees recovered more than $18 million in savings on behalf of consumers. In addition to helping consumers with immediate problems, Consumer Assistance Programs will help consumers understand other health care reforms designed to make the Health Insurance Marketplace more competitive and patient-centered in 2014 and beyond.

For More Information

•    Contact the Consumer Assistance Program in your state.
•    Find detailed technical and regulatory information on Consumer Assistance Program grants.
•    HealthCare Blog: Consumer Protections: Applying New Protections to Your Health Plan.

Posted on: July 12, 2010

Last updated: February 14, 2013