What is the role of a healthcare ombudsman?

UPDATED: Jun 11, 2012

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UPDATED: Jun 11, 2012Fact Checked

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Asked June 11, 2012

1 Answer

Health insurance, like other insurance products, is monitored and licensed on a state by state basis. In order to help those who may have trouble finding insurance through traditional channels, each state's Department of Insurance names a Healthcare Ombudsman whose job it is to help resolve health insurance related problems faced by citizens of the state.

The healthcare ombudsman acts as the link between consumers, those who need health coverage, and insurance providers. The healthcare ombudsman is employed by the state department of insurance, and works with consumers to resolve conflicts, determine long-term care needs, and provide guidance in bringing insurance carriers and the people who need them together. In many respects, the healthcare ombudsman can be considered as a mediator between the people and the insurance companies.

The health care ombudsman is your last resort for assistance if you are having trouble buying health insurance. The role of the health care ombudsman includes helping you track down special coverage, find alternative to traditional health policies which may not provide coverage for your needs, and to provide you with information about insurance companies and the state law, acting as your source for information on how and where to look for the coverage you need.

In a world with an increasing percentage of aging people, the health care ombudsman is also a source for assistance in finding long term care for the elderly or other people who are traditionally difficult to insure. Knowing the needs of the people and having a working knowledge of the insurance industry means that people can turn to their health care ombudsman for help in getting coverage even when their other options seem to be few and far between.

Answered June 11, 2012 by Anonymous

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