Your Medicare appeals and grievances in Texas

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 solve your problem over the phone. We can even send you a written response to if you ask for one.

If we can’t solve 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 either by phone or in writing.

• Call Member Services at Toll Free: (866) 856-8699 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 Attn: Appeals & Grievances
  • P.O. Box 22816Long Beach, CA 90801-9977
• Log in to the Molina Member Portal to file your grievance electronically

We will respond to all quality of care grievances in writing, no matter how it was filed.

For more information, see Chapter 9 of your EOC.

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

Read your EOC booklet

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

Explore the EOB