Health Plan Grievance Forms
A Health Services assigned managed care member may file a grievance by completing the grievance form and mailing it to the address listed below. The member may file a grievance online by using the link below to the health plan’s website.
LA Care Health Plan
Appeals and Grievances
1200 W. 7th Street
Los Angeles, California 90017
Tel no. 1- 888-839-9909
Fax no. 1-213- 438-5748
Website: http://www.lacare.org/
L.A. Care Grievance Form (Multiple languages)
A Health Services assigned managed care member may file a grievance by completing the grievance form (below) and mailing it to the address listed below. The member may file a grievance online by using the link below to the health plan’s website.
Health Net of California
Member Appeals and Grievance Department
PO Box 10348
Van Nuys, California 91410-0348
Tel no. 1-800-675-6110
Fax no.1-877-831-6019
Website: https://www.healthnet.com/
Health Net Grievance Form (Multiple Languages)
A Health Services assigned managed care member may file a grievance by completing the grievance form (below) and mailing it to the address listed below. The member may also file a grievance online by using the link below to the health plan’s website.
Molina Healthcare of California
Grievance and Appeals Unit
200 Oceangate, Suite 100
Long Beach, California 90802
Tel no. 1-888-858-2150
Fax 1-562- 499-0757
Molina Healthcare Grievance Form (Multiple languages)