Your dual-eligible appeals and grievances in Massachusetts

If you are unhappy with your care, complain about:

• The care you get from your provider.
• The time to get an appointment or to be seen.
• The providers you can choose for care.

File an appeal if you do not agree with a Molina decision to:

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

Filing a grievance with Molina

Call Member Services first. We try to fix the problem by phone. Ask for a written response if you want one

If the problem is not fixed by phone, use the formal Member Grievance Process. File a grievance within 60 days of the start of the issue. File by phone or in writing.

• Call Member Services:

Senior Whole Health SCO:(888) 794-7268 (TTY: 711)

Molina One Care:(833) 775-1735 (TTY: 711)

• Fill out the Member Grievance Form and fax your complaint to (562) 499-0610
• Fill out the Member Grievance Form and mail it to:

Molina Healthcare

Attn: Appeals & Grievances

PO Box 22816

Long Beach, CA 90801-9977

• Log in to the Member Portal to file your grievance electronically

We send a written reply to all quality of care grievances. For more information, see Chapter 9 of your Member Handbook.

You can also submit a complaint through Medicare at https://www.Medicare.gov.

Read your Member Handbook

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

Explore the handbook