There’s a resource for beneficiaries enrolled in Cal MediConnect: the Cal MediConnect Ombudsman Program. If you have a problem with your services or Cal MediConnect plan, you can turn to the Ombudsman program for help.
If you are having a problem with your Cal MediConnect plan, try to talk to your doctor and your health plan. If your plan has denied coverage or payment for a medical service, the plan will have a process for you to appeal that decision.
If the problem is still not fixed, you have more options for help, including the Cal MediConnect Ombudsman program. The Ombudsman can help you ask for “continuity of care,” which can help you keep seeing your doctors after joining a Cal MediConnect plan. They can also help you file an appeal if your plan has denied a service or treatment.
For More Information
- Read a sample Integrated Denial Notice on your options if your plan denies a claim.
- Read more about your Rights & Responsibilities.
- To learn more about how the Ombudsman Program was founded, .
Other Resources for Help
If you need help understanding your health plan choices, contact the Health Insurance Counseling & Advocacy Program, or HICAP (1-800-434-0222).
If you want to make a change to your health plan, including choosing a different Cal MediConnect plan, a different Medi-Cal plan, or to opt out of Cal MediConnect, contact Health Care Options (1-844-580-7272).
For appointments at all Ombudsman offices, call HCA’s toll-free number, 1-888-804-3536. Business hours will vary by location.
|Los Angeles County||Neighborhood Legal Services of Los Angeles County||13327 Van Nuys Boulevard
Pacoima, CA 91131
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Glendale, CA 91205
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El Monte, CA 91731
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San Diego, CA 92110
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Redwood City, CA 94065*
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San Jose, CA 95113
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