Members

How to File a Complaint

Medical symbol caduceus snake with stick

Members can file a complaint over the phone with member services. Members must file a grievance in writing within ninety (90) days from the day the incident or action occurred, which caused the member to be unhappy.

To file a complaint, you can:

 

To file a grievance, you can:

  • Write a letter and mail it to:
    Molina Healthcare of Wisconsin
    Grievance and Appeals Unit
    PO Box 242480
    Milwaukee, WI 53224-9931

 

  • Be sure to include the following:
    • Member’s first and last name
    • ForwardHealth / Medicaid ID number. It is on the front of the ForwardHealth ID Card
    • Member’s address and telephone number
    • Explain the problem

 

If you want to talk to someone outside of Molina Healthcare Health Plan about the problem, call the HMO Enrollment Specialist at (800) 291-2002. The Enrollment Specialist may be able to help you solve the problem, or can help you write a formal grievance to Molina Healthcare Health Plan or to the BadgerCare Plus and Medicaid SSI programs.

You may also file a complaint with the Wisconsin BadgerCare Plus and Medicaid SSI Program.  Please call Molina
Healthcare’s Member Advocate if you need help to write a formal grievance to Molina Healthcare Health Plan or to the BadgerCare Plus and Medicaid SSI programs.
The address to complain to the Wisconsin BadgerCare Plus and Medicaid SSI Programs is:

BadgerCare Plus and Medicaid SSI
Managed Care Ombuds
P.O. Box 6470
Madison, WI 53716-0470
 
If your complaint or grievance needs action right away because a delay in treatment would greatly increase the risk
to your health, please call Molina Healthcare as soon as possible at (888) 999-2404 or (800) 947-3529.
 
We cannot treat you differently than other members because you file a complaint. Your health care benefits will not be affected.
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.