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Frequently Asked Questions Insurance

If I am enrolled in a DC Health Link plan, will I follow the same claims dispute process as an enrollee in an OPM-contracted FEHB plan, if I disagree with my DC Health Link plan’s decision about benefits coverage or the provision of a medical service?

No.  There are separate external appeal provisions that apply to health plans participating in the DC Health Link.  You can contact the Healthcare Ombudsmen at (877) 685-6391, Monday –Friday from 8:15 AM – 4:45 PM EST, or the Department of Insurance Securities & Banking (DISB) at (202) 727-8000, Monday – Friday from 8:15 AM – 4:45 PM EST.  For more information, please contact your agency’s benefits officer.

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