State guide

Alaska

Pick the kind of plan you have to see who to call first. Alaska can only help with plans it regulates.

On this page 8

Which plan do you have?
Quick facts for independent review
Who regulates health plans
Independent (external) review
Free help in Alaska
Medicare and Medicaid in Alaska
State laws that can help
Sources and what we could not confirm

Which plan do you have? Who to call first, by coverage

Your employer pays claims itself

Alaska usually cannot help with these plans. Call the Employee Benefits Security Administration.

Call 1-866-444-3272
Insurance you buy, or an employer plan bought from an insurer

Call Alaska Division of Insurance (Department of Commerce, Community, and Economic Development). See the at-a-glance box.

Call 907-269-7900
Medicaid or children's coverage

Call the number on your notice and ask to appeal, and to keep services going while you appeal. The hearing deadline is under Medicaid in Alaska.

Medicaid in Alaska
Medicare

Alaska Medicare Information Office (Alaska's State Health Insurance Assistance Program) gives free counseling. Or call 1-800-MEDICARE.

Call 1-800-478-6065 1-800-633-4227

The short version for Alaska

Alaska runs its own external review through the Division of Insurance, which assigns an independent review organization itself; the review is free and you get 180 days to ask, longer than the four months most states allow. Alaska has no separate consumer assistance program or health care ombudsman on the federal list, so the Division's Consumer Services section is the main place to get help with a private-plan denial. A new prior authorization and step therapy law (Senate Bill 133) only applies to plans issued or renewed on or after January 1, 2027.

At a glance: independent review for plans Alaska regulates

This box is for insurance you buy, or an employer plan bought from an insurer. It is not for Medicaid, Medicare or a plan your employer funds itself.

Main regulator: Alaska Division of Insurance (Department of Commerce, Community, and Economic Development) · 907-269-7900 or 1-800-INSURAK (in-state, outside Anchorage)
Independent review: A state process (External Healthcare Review (external review))
Deadline to request it: 180 days after you receive the insurer's final denial (called a final adverse determination). The Division will extend the deadline if you ask in writing and give a fair and reasonable justification.
Cost: None. The insurance company pays the cost of the review.
Decision time: Up to 45 days after the independent review organization accepts the case (20 days if the denial was for experimental or investigational treatment); fast track: 72 hours (for an expedited experimental or investigational review: completed within 5 days, with the written decision no later than 48 hours after that)

Your own notice states the deadline and process for your plan, and controls if it differs. Plans your state does not regulate (for example job-based plans the employer funds itself) follow federal rules; see who regulates your plan.

Who regulates health plans

Alaska does not publish an insurance-card tip. The Division of Insurance explains that a self-funded (also called self-insured) employer plan is not an insurance policy, and that an insurance company may simply process claims for it as a third-party administrator, so the company name on your card does not settle the question. Ask your employer's benefits office whether your plan is fully insured or self-funded, or call the Division's Consumer Services section at 907-269-7900. The federal Centers for Medicare & Medicaid Services (CMS) says people with a self-insured employer plan should contact the U.S. Department of Labor's Employee Benefits Security Administration at (866) 444-3272.

Alaska Division of Insurance (Department of Commerce, Community, and Economic Development)
Health and dental insurance policies sold by insurance companies in Alaska, including plans you buy yourself (on or off HealthCare.gov) and fully insured employer plans. It does not regulate self-funded (self-insured) employer plans, Medicaid or Medicare.

Phone: 907-269-7900 or 1-800-INSURAK (in-state, outside Anchorage). File a complaint online

Independent (external) review

Process: A state process. Run by Alaska Division of Insurance, Consumer Services section, which assigns an approved independent review organization (IRO) by rotation.
Where you file: regulator
How: Fill in the Division's External Review Application Form (for the patient or a parent or legal guardian) or the Third-Party External Review Application Form (for a doctor or anyone else applying for the patient), and email it to consumerservices@alaska.gov or fax it to 907-269-7910; the Division asks you not to mail it, to avoid delay. Include your final denial letter and sign the medical records release. If the case is urgent, your physician also completes the Provider Certification Form; call 907-269-7900 and ask for Consumer Services with questions.
Which denials qualify: Denials by a health care insurer regulated by the Division that are based on medical necessity, appropriateness, health care setting, level of care or effectiveness, and denials of treatment the insurer calls experimental or investigational. It is not for contract disputes such as how a deductible or copay was applied or whether a dependent is eligible; the Division may still look at those as a complaint.
Appeal to the plan first?: Yes, you normally must finish the insurer's internal appeal (grievance) first. Exceptions the state lists: urgent cases where waiting would seriously jeopardize your life, health or ability to regain maximum function (expedited review); the insurer missed its own deadlines or other requirements, for example no written decision within 30 days of your grievance; or the insurer agrees to waive the internal appeal.
Published results: The Division's 87th Annual Report (calendar year 2024 / fiscal year 2025) charts 65 external review applications, 30 reviewed by an independent review organization, 21 insurer decisions upheld and 9 overturned (about 30% of the reviewed cases overturned). Source

Official page

General rules and what to send: how external review works, how to request it.

Free help in Alaska

Alaska Division of Insurance, Consumer Services section
Investigates complaints about claim denials and claim delays under state-regulated insurance at no charge, asks the company to explain its position, and handles external review requests; it cannot give legal advice or act as your lawyer.

Phone: 907-269-7900 or 1-800-INSURAK (in-state, outside Anchorage)
Alaska Legal Services Corporation
Free civil legal aid for low-income Alaskans, including advice and representation on access to Medicaid, Medicare and Denali KidCare (the children's health program) and at Medicaid fair hearings; it cannot take every case.

Phone: 1-888-478-2572
Disability Law Center of Alaska
Independent non-profit law firm for people with disabilities anywhere in Alaska; the state's Medicaid fair hearing notice names it as a possible source of free legal help with a Medicaid denial.

Phone: (800) 478-1234 statewide; (907) 565-1002 in Anchorage
U.S. Department of Labor, Employee Benefits Security Administration (EBSA)
Benefits advisors help workers with questions, complaints and disputes about employer health plans, including the self-funded plans that the Alaska Division of Insurance does not regulate.

Phone: 1-866-444-3272

Medicare and Medicaid in Alaska

Medicare counseling: Alaska Medicare Information Office (Alaska's State Health Insurance Assistance Program) · 1-800-478-6065 (in Anchorage: 907-269-3680) . Free help with Medicare appeals.
Medicaid agency: Alaska Department of Health — Alaska Medicaid, and Denali KidCare for children
Fair hearing deadline: 30 days from the date on the decision letter. Your notice states the deadline that applies to you.
Good to know: For a denied service or prior authorization, request the hearing by email or text to fairhearings@gainwelltechnologies.com, fax (907) 644-8126, or phone (907) 644-6800 or (800) 780-9972 (options 2, 3, 2). Problems with eligibility, renewals or terminations go to the Division of Public Assistance instead at (800) 478-7778. The state usually offers a telephone mediation before the hearing. If you already receive the benefit and ask for a hearing, it may continue while you wait, but you may have to repay the cost if you lose. You can ask for an expedited hearing if waiting would jeopardize your life, health or ability to function.

Medicaid appeals page How Medicaid appeals work

State laws that can help

External review. You can ask the Division of Insurance for a free, binding review by an independent review organization within 180 days of a final denial, and the insurer must comply immediately if the reviewer reverses the denial.

Alaska Statutes 21.07.005; Alaska Administrative Code 3 AAC 28.950 – 28.982
Prior authorization. Once your insurer has preauthorized a covered procedure as medically necessary, it may not go back and deny it later unless the approval was based on materially incomplete or inaccurate information from the provider.

Alaska Statutes 21.07.020(1)
Prior authorization. For plans issued or renewed on or after January 1, 2027, insurers must answer a complete prior authorization request within 72 hours (24 hours if expedited), and a request counts as approved if the insurer misses the deadline; approvals for chronic conditions must also last longer.

Senate Bill 133 (Chapter 21, Session Laws of Alaska 2025), adding Alaska Statutes 21.07.100 – 21.07.180
Step therapy. For plans issued or renewed on or after January 1, 2027, insurers must offer a clear process to request an exception from step therapy (being made to try other drugs first) and must grant it if you already tried and stopped the required drugs or your provider attests the drug is needed to save your life; step therapy is barred for covered drugs treating Stage 4 advanced metastatic cancer.

Senate Bill 133 (Chapter 21, Session Laws of Alaska 2025), adding Alaska Statutes 21.07.160
Denial notice. A denial notice must be in plain language and give the reason, the policy terms relied on, an explanation of the medical codes and your appeal rights, and the final denial must tell you about external review, help from the Division of Insurance and your right to sue.

Alaska Administrative Code 3 AAC 28.900 – 28.938
AI in utilization review. This is regulator guidance, not a statute: the Division of Insurance told insurers that decisions affecting consumers that are made or supported by artificial intelligence must still comply with Alaska's unfair trade practices and unfair claims settlement laws, and that it may ask how those systems are governed.

Alaska Division of Insurance Bulletin B 24-01 (February 1, 2024)
Mental health parity. Alaska relies on the federal parity law: the Division of Insurance says it makes individual and small-group insurers certify compliance every year, examines insurers in all markets, takes parity complaints and can fine insurers that fall short.

Federal Mental Health Parity and Addiction Equity Act, as enforced by the Division of Insurance (Division letter to the Senate Health and Social Services Committee, April 29, 2025)

State laws usually reach only plans your state regulates. They often do not reach job-based plans the employer funds itself.

Sources and what we could not confirm

Read from official pages on 2026-11-11. Phone numbers and deadlines change; check the official page before you rely on one.

Not confirmed (13)

The independent review request form. the application forms and the 'Guide to External Review' are linked from the Division's external review page, but commerce.alaska.gov returned HTTP 403 to every direct fetch and browser tool; the page text was read through a crawler that drops link addresses, so no form address could be confirmed. Set to null; send readers to externalReview.url.
Where to file for independent review. the Division's web page and regulation 3 AAC 28.958 say the request goes to the Division (the director). Third-party summaries of the Division's 'Guide to External Review' (June 2025), which could not be loaded, say it may be sent to the insurer or the Division. Recorded as 'regulator'.
Not confirmed. regulators[0].regulates and externalReview.eligibleDenials — the statement that self-funded employer plans, Medicaid, Denali KidCare and Medicare are outside the Division's external review comes from third-party summaries of the unloadable Guide plus the Division's 'Insurance Terms Defined' page and the CMS consumer help page, not from the Guide itself.
Published results of independent review. the figures (65 applications, 30 reviewed, 21 upheld, 9 overturned) were read from the text layer of a chart on page 11 of the 87th Annual Report, where data labels are mixed with axis numbers; the chart image could not be viewed and the report does not say in the extracted text whether the period is calendar year 2024 or fiscal year 2025. The 30% rate is my calculation (9 of 30).
How to file for independent review. the Division's page is internally inconsistent on large files: one paragraph says to call about files larger than 50 MB, another says to contact Consumer Services if a submission exceeds 15 MB.
How long a standard independent review takes. the Division's 2018 FAQ says 'up to 45-days'; the Director's April 19, 2024 letter says 45 days 'from when they accept the assignment'. The 20-day and 5-day experimental or investigational timelines come only from that letter.
A searchable list of past decisions. no searchable database of past external review decisions was found on the Division's site; null.
The state regulators. the toll-free number is printed only as letters (1-800-INSURAK) on the official site; no numeric form was confirmed there.
Free consumer help programs. the CMS 'Alaska Health Insurance Consumer Help' page lists no Consumer Assistance Program or ombudsman for Alaska, only the Division of Insurance, the Department of Health, the Department of Labor and the Medicare counseling program. Alaska Legal Services Corporation's site describes help with Medicaid, Medicare and Denali KidCare, not private insurance denials.
Notes on Medicaid appeals. the mailing address differs between official pages (P.O. Box 240808, Anchorage, AK 99524 on the fair hearing rights notice and recipient handbook; 99521 on the Alaska Medicaid Fair Hearings web page), so it was left out. The CMS page prints the Medicaid phone as 800-487-7778; the state's own pages print 800-478-7778, which is used here. Whether any Alaska Medicaid member must first appeal to a managed care plan was not confirmed on an official page.
State laws that help. the official akleg.gov statute viewer loads text by script and returned only the table of contents; the wording of Alaska Statutes 21.07.020(1) was confirmed in enrolled House Bill 372 (2016) on akleg.gov and in a 2025-edition mirror (both in sources).
Not confirmed. stateLaws[2] and stateLaws[3] — Senate Bill 133 is not yet in force on the verification date; it applies to plans issued or renewed on or after January 1, 2027, and the Division's implementing regulations were still being written per its annual report. The 'approvals for chronic conditions must last longer' point comes from the Alaska Senate press release, not from a section of the bill text I read.
Not confirmed. stateLaws (surprise billing) — no state surprise-billing law is listed. The Division's 2022 notice still describes the '80th percentile' payment rule (3 AAC 26.110); a third-party source says it was repealed effective January 1, 2024, which was not confirmed on an official page.

Sources last checked 11 November 2026. Found a mistake? Report it.