Members

Member Grievances and Appeals

As a Molina MyCare Ohio Medicaid member, if you have a problem with your medical care or our services, you have the right to file a grievance or appeal.

You can file a grievance when you are unhappy with Molina MyCare Ohio Medicaid, your provider or 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.

You can file an appeal when you do not agree with our decision to:

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

We want you to understand the grievance and appeal process. We can help you through each step.

How to:


To learn more about filing an expedited appeal or request a state hearing, view the Member Handbook.

*Printed copies of information posted on our website are available upon request.

 

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.