We Can Not Open an Appeal Case For This Reason
The reason may be because it does not involve buying a health plan or Catastrophic coverage, getting financial savings to help with Pennie costs, Special Enrollment Period denials, or getting an exemption.
However, we have outlined ways for you to get help with several different issues below.
Billing or Claims Issues
Contact your Insurance Company for billing and claims issues, or if they terminated your plan due to non-payment.
Pennie cannot help if your insurance company:
- Terminated your coverage due to non-payment.
- Incorrectly processed your bills or payments.
- Is not processing or is denying your claims.
You may file an appeal with your health insurance company if you disagree with their decision by calling them at the number on your insurance card.
If their answer was not satisfactory, the Pennsylvania Insurance Department (PID) may be able to help you. You can call them at 1-877-881-6388 or visit their website.
Federal Income Taxes and Repayments
Contact a tax professional about federal income taxes and repayments.
You cannot appeal if the IRS says you must repay the financial savings you received to lower your monthly payments. These savings are also known as Advanced Premium Tax Credits. Pennie uses the information from your application to determine the amount of savings you were given. This is why it is critical to make application updates throughout the year as household changes occur.
Please consult a tax professional if you have filed your federal income tax return and are disputing having to repay some or all the Advanced Premium Tax Credits used. See Internal Revenue Service (IRS) publication 974 to learn more.
You Did Not Want to be Considered for Medicaid or CHIP
Contact the Department of Human Services (DHS) if you completed a Pennie application and they now are checking for Medicaid or CHIP eligibility.
Based on your household size, income, and other factors on your application, Pennie is required to send your information to DHS to see if you or someone in your household qualifies for Medicaid or CHIP.
Pennie cannot start an appeal for you if your application was sent to DHS and they are still reviewing your information.
Pennie has to wait for DHS to review your file and determine eligibility for such programs. Once Pennie receives DHS’ determination, changes may be able to be applied to your application. You can call DHS at 1-877-395-8930. If you live in Philadelphia County, you can call them at 215-560-7226.
File Complaint With Pennie
Contact Pennie’s Complaint Department if your matter is not listed above.
Please see instructions below.
- Call Pennie at 844-844-8040 to request a Complaint ticket be created, or
- Log into your Pennie account
- From you Pennie Dashboard, select “My Tickets”.
- Create a new ticket.
- Add supporting documents and click “Submit”.
- Follow up on your case or add comments via “Ticket History” or by calling Pennie.
Please allow 30 days for a Pennie team member to contact you.
