Appeals and grievances in Idaho

As a Molina Healthcare member, you have the right to file a complaint (grievance) if you have a problem with your medical care or our services. Some examples are:

• The care you get from your provider

• The time it takes to get an appointment or see a provider

• The providers you can choose for care

An appeal can be filed when you do not agree with our decision to:

• Stop, change, suspend, reduce or deny a service

• Deny payment for services provided

To file an appeal or grievance, you can:

• Call Molina Healthcare at (833) 657-1981 (TTY:711), Monday through Friday, 8:00 a.m. to 6:00 p.m. local time. We will try to help you over the phone. 

• Log in to the My Molina Member Portal

We will send you a letter acknowledging receipt of your appeal or grievance within 3 calendar days and issue a formal response within 30 calendar days for grievances and 14 calendar days for appeals.

For state assistance, you can call the Idaho Department of Insurance Commissioner’s Consumer Affairs Section at (800) 721-3272 or (208) 334-4319 or visit https://doi.idaho.gov/consumer/Complaint.

For more information, check your member handbook or your agreement and evidence of coverage.

Read your Member Handbook

Your Member Handbook explains covered services, programs, rewards, and how to use your benefits. Keep it handy when you need care. Explore your handbook.

Helpful resources

Learn about services that are covered by your plan, such as primary care, virtual care, mental health, prenatal care and hospital care.

• Benefits and services 
• Drug coverage