Choose Your HEAU Complaint to Print and Mail In

APPEAL OF MARYLAND HEALTH CONNECTION DECISION button

Use this form if you would like our assistance in filing an appeal of a Maryland Health Connection decision denying Qualified Health Plan coverage or denying Advanced Premium Tax Credits or Cost-Sharing Reductions.

MEDICAL BILLING OR EQUIPMENT DISPUTE button

Use this form if you have a billing dispute with your hospital, doctor, dentist, or other healthcare provider. You can use this form if you are seeking a refund for medical equipment that is defective or was never delivered, or if you have other medical equipment problems.

HEALTH INSURANCE CLAIM DENIED button

Use this form if your health plan has refused to pay for a service, is refusing to pay for future treatment, or has paid less than you think they should have paid for your treatment/service.  You can also use this form for other health insurance disputes.

PROVIDER COMPLAINT FORM button

Use this form if you are a healthcare provider filing a complaint on behalf of your patient.

NON-HEALTH CARE COMPLAINT button

Use this form if your complaint is not about medical healthcare issues.

ONLINE FORMS button

Are you looking for online forms instead of the printable ones listed on this page?


Office of the Attorney General, Health Education and Advocacy Unit
200 St. Paul Place, 16th Floor
Baltimore, MD 21202

(410) 528-1840
FAX (410) 576-6571
Toll-free in Maryland
1-877-261-8807
Email: heau@oag.state.md.us

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