Complaints

A complaint (or grievance) is when you have a problem or are unhappy with the services you are receiving from L.A. Care or a provider.

There is no time limit to file a complaint. You can file a complaint with L.A. Care at any time by phone, in person, in writing or online.

  • Online:
    You can submit an online Grievance Form.
  • By Phone:
    Call L.A. Care Member Services at 1-888-839-9909 (TTY: 711) 24 hours a day 7 days a week including holidays. Give your health plan ID number, your name and the reason for your complaint.
  • By Mail:
    Call L.A. Care at 1-888-839-9909 (TTY: 711) and ask to have a form sent to you.
    When you get the form, fill it out. Be sure to include your name, health plan ID number and the reason for your complaint. Tell us what happened and how we can help you.

    Mail the form to:
          L.A. Care Health Plan
          Appeal and Grievance Department
          1055 West 7th Street, 10th Floor
          Los Angeles, CA 90017

If you need help filing your complaint, we can help you. We can give you free language services. Call L.A. Care Member Services at 1-888-839-9909 (TTY: 711).

Within 5 days of getting your complaint, we will send you a letter letting you know we got it.
Within 30 days, we will send you another letter that tells you how we resolved your problem.

If you call L.A. Care about a grievance that is not about health care coverage, medical necessity, or experimental or investigational treatment, and your grievance is resolved by the end of the next business day, you may not receive a letter.

If you want us to make a fast decision because the time it takes to resolve your complaint would put your life, health or ability to function in danger, you can ask for an expedited (fast) review.
To ask for an expedited review, call us at 1-888-839-9909 (TTY: 711). 
Within 72 hours of receiving your complaint, we will make a decision about how we will handle your complaint and whether we will expedite your complaint.
If we determine that we will not expedite your complaint, we will let you know that we will resolve your complaint within 30 days.

Complaints related to Medi-Cal Rx pharmacy benefits are not subject to the L.A. Care grievance process or eligible for Independent Medical Review.
Members can submit complaints about Medi-Cal Rx pharmacy benefits by calling 1-800-977-2273 (TTY 800-977-2273 and press 5 or 711) or visiting the Medi-Cal Rx website.
However, complaints related to pharmacy benefits not subject to Medi-Cal Rx may be eligible for an Independent Medical Review.

You can find the Independent Medical Review / Complaint form and instructions online at the DMHC’s website. You can also call DMHC’s toll-free telephone number at 1-888-466-2219 (TTY 1-877-688-9891).