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Complex Case Web Form

The Centers for Medicare & Medicaid Services (CMS) is excited to announce an initiative and tool for federally certified application counselors (CACs) and Navigators in a Federally-facilitated Marketplace (FFM) to help assist consumers with complex cases. 

What is a Complex Case?A complex case is a case involving a single consumer or tax household where the assister has been unable to resolve a specific issue on the consumer or tax household’s application for Marketplace coverage, despite efforts to correct it with the Marketplace Call Center.

• At this time, only federally certified application counselors (CACs) or Navigators in a Federally-facilitated Marketplace (FFM) may submit complex cases.

• Complex cases are NOT policy questions or general questions about the Marketplace application.

Learn More About the Complex Case Initiative

Register for our live webinar – Please join CMS on February 5, 2021 from 2:00-3:30 ET for a live webinar that will educate and introduce Complex Cases and the Complex Case web form to the CAC community.

Register here

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