“The California Department of Managed Health Care is responsible for regulating health care service plans. If you have a grievance against your health plan, you should ﬁrst telephone your health plan at 1-800-321-2843 and use your health plan’s grievance process before contacting the department. Utilizing this grievance procedure does not prohibit any potential legal rights or remedies that may be available to you. If you need help with a grievance involving an emergency, a grievance that has not been satisfactorily resolved by your health plan or a grievance that has remained unresolved for more than 30 days, you may call the department for assistance. You may also be eligible for an Independent Medical Review (IMR). If you are eligible for IMR, the IMR process will provide an impartial review of medical decisions made by a health plan related to the medical necessity of a proposed service or treatment, coverage decisions for treatments that are experimental or investigational in nature and payment disputes for emergency or urgent medical services. The department also has a toll-free telephone number (1-888-HMO-2219) and a TDD line (1-877-688-9891) for the hearing and speech impaired. The department’s Internet Web site www.hmohelp.ca.gov has complaint forms, IMR application forms and instructions online.”
IMPORTANT: You can get an interpreter at no cost to talk to your doctor or Health Insurance Company. To get an interpreter or to ask about written information in (your language), first call your insurance company’s phone number at 1-800-321-2843. Someone who speaks (your language) can help you. Someone who speaks Spanish can help you. If you need additional help, call the HMO Help Center at 1-888-466-2219.
IMPORTANTE: Puede obtener la ayuda de un intérprete sin costo alguno para hablar con su médico o con su plan de salud. Para obtener la ayuda de un intérprete o preguntar sobre información escrita en español, primero llame al número de teléfono de su plan de salud al 1-800-321-2843. Alguien que habla español puede ayudarle. Si necesita ayuda adicional, llame al Centro de ayuda de HMO al 1-888-466-2219.
California Relay Service (CRS)
If you have limitations hearing or speaking, please utilize the phone numbers below to have a CRS representative assist you.
Type of Call, Language, Toll-free Number:
TTY/VCO/HCO to Voice
Voice to TTY/VCO/HCO