Members

Member Grievances (Complaints) and Appeals

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

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 can be filed when you are unhappy with your care. Some examples are:

  • The way you were treated;
  • The quality of care you get from your provider;
  • Problems getting care;
  • Billing issues; and
  • Attitude and service.

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    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.

    If you need help, call (800) 869-7165, TTY 711. We will keep your information private. If you do not speak English, we can help. If you need any information in a language other than English, call us at (877) 644-4613, TTY 711.  We will provide language assistance at no cost to you.  

    HOW TO:

     

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.