There are two ways to report and solve problems:
- Use a complaint (grievance) when you have a problem or are unhappy with L.A. Care or a provider or
with the health care or treatment you got from a provider - Use an appeal when you don’t agree with L.A. Care’s decision to change your services or to not cover them.
You have the right to file grievances and appeals with L.A. Care to tell us about your problem. This does not take away any of your legal rights and remedies. We will not discriminate or retaliate against you for filing a complaint with us or reporting issues. Telling us about your problem will help us improve care for all members.
You may contact L.A. Care first to let us know about your problem. Call us 24 hours a day, 7 days a week, including holidays at 1-888-839-9909 (TTY: 711). Tell us about your problem.
For complaints, grievances, and appeals you may also reach us by:
- Phone: 1-888-839-9909 (TTY 711)
- Fax: 1-213-438-5748
- Mail: L.A. Care Health Plan
Appeals and Grievances Department
1055 W 7th Street, 10th Floor
Los Angeles, CA 90017 - Online: L.A. Care Grievance and Appeal Form
If your grievance or appeal is still not resolved after 30 days, or you are unhappy with the result, you can contact the California Department of Managed Health Care (DMHC). Ask them to review your complaint or conduct an Independent Medical Review (IMR).
If your matter is urgent, such as those involving a serious threat to your health, you may call DMHC right away without first filing a grievance or appeal with L.A. Care.
Visit the DMHC website or call them at 1-888-466-2219 (TTY 1-877-688-9891 or 711).
The California Department of Health Care Services (DHCS) Medi-Cal Managed Care Ombudsman can also help. They can help if you have problems joining, changing, or leaving a health plan. They can also help if you moved and are having trouble getting your Medi-Cal transferred to your new county. You can call the Ombudsman Monday through Friday, 8:00 a.m. to 5:00 p.m. at 1-888-452-8609. The call is free.
You can also file a grievance with your county eligibility office about your Medi-Cal eligibility.
If you are not sure who you can file your grievance with, call L.A. Care Member Services at 1-888-839-9909 (TTY: 711).
To report incorrect information about your health insurance, please call Medi-Cal Monday through Friday, between 8:00 a.m. and 5:00 p.m. at 1-800-541-5555.