External Appeals of Healthcare Denials
If your insurer or HMO denies health care services as not medically necessary, experimental/investigational or out-of-network, you have the right to appeal to the Department of Financial Services. This appeal is known as an external appeal. Health care providers also have the right to an external appeal when health care services are denied (concurrently or retrospectively).
- Learn how to file an External Appeal.
- Search and review prior external appeal decisions using our External Appeals Database.
Consumer Protections Under The Federal No Surprises Act
Prescription Drug Price Spikes
DFS investigates significant price increases for certain drugs sold or advertised in New York State and requires companies show reasonable justification for sudden increases.
- Learn how to report a spike in a prescription drug price
Mental Health and Substance Use
- Mental Health and Substance Use Disorder Information for Consumers
Infertility, Fertility Preservation, and Surrogacy
- FAQs for Infertility Services, Fertility Preservation Services, and Health Care Services Related to Surrogacy
Child Health Plus
Every child in New York who is under age 19 who does not have health insurance is eligible for the Child Health Plus program. Child Health Plus offers comprehensive health coverage, including physician visits, hospital stays, outpatient care and prescription drugs. No copayments apply. Visit the Department of Health for more information on Child Health Plus or call (800) 698-4543 or your local department of social services or department of health.
DFS oversees the Healthy NY program in partnership with HMOs and other insurance companies in New York State, to offer comprehensive health insurance to small businesses.
NY State of Health Marketplace
The New York State of Health Marketplace can help you shop for and enroll in health insurance. You can use the Exchange to compare options and prices offered through the Exchange, calculate costs and enroll in coverage online, in person, over the phone or by mail. You may also qualify to receive federal tax credits to help pay for insurance offered through the Exchange.
Public Access to Accident & Health Insurance Form Filings
Certain accident & health insurance policy filings and Plan Management filings are made available for public viewing online via the NAIC SERFF State Filing Access website. Filings disposed of on and after February 27, 2018 are available there. (Filings may be updated or changed by a subsequent filing. You should search for the most recent version of the filing.) The Department is not responsible for any errors in or omissions from the filings. Filings may contain material that is protected by copyright laws and no person may reproduce, redistribute, or make commercial use of any such material in violation of those laws. The public may also obtain access to filings by submitting a Freedom of Information Law (FOIL) request to the Department.