Members

Complaints, Grievances, & Appeals

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Member Complaint (Grievance) and Appeals

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

  • 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.

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 complaint (grievance) process and can help you through each step.

HOW TO:

 

You may request printed copies of all our content posted on our website. All appeals and grievances, forms associated services are available free of charge.

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.