Members

Member Grievance (Complaint) and Appeals

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As a Molina Healthcare member, if you have a problem with your medical care or our services, you have a right to file a grievance (complaint) or appeal. A grievance (complaint) can be filed when you are unhappy with your care. Some examples are:

  • You are unhappy with the care you received from your provider.
  • You are unhappy with the selection of providers you can choose from for care.
     

An appeal can be filed when you do not agree with Molina Healthcare’s decision to:

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

We want you to have access to the grievance (complaint) process and can help you through each step.

HealthChoice Illinois Member Handbook

It tells you what you need to know about member grievances and appeals. Read here.
You may have to pay for services that are not covered. You may also have to pay for services from providers not part of our network. If the services were an emergency, you don’t have to pay. If you need help, call Member Services.