Your Medicare appeals and grievances in California

If you are unhappy with your care, you can complain about:

• The care you get from your provider
• The time it takes to get an appointment or be seen by a provider
• The providers you can choose for care

You can also file an appeal if you don’t agree with a Molina decision to:

• Stop, change, suspend, reduce or deny a service
• Deny payment for services provided

Filing a grievance with Molina

If you have a complaint, please call Member Services first. We will try to resolve your problem over the phone. We will send you a written response if you ask for one.

If we can’t correct your problem over the phone, you can use our formal member grievance process. You must file a grievance within 60 days of the start of your issue.

You can file a grievance by phone, mail, fax or electronically. Here are your options:

• Call Member Services at (800) 665-0898 (TTY: 711).
• Fill out the Member Grievance Form and fax it to (562) 499-0610.
• Fill out the Member Grievance Form and mail it to:
  
  Molina Healthcare
  Attn: Appeals & Grievances
  P.O. Box 22816
  Long Beach, CA 90801-9977
• Log in to the My Molina member portal to file your grievance electronically.
• Submit a complaint through Medicare.

We respond to all quality of care grievances in writing, regardless of how the grievance was filed.

For more information, see Chapter 9 of your EOC.

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