Whether getting yearly checkups or dealing with a serious health crisis, you may face problems with your doctor or healthcare insurance. Here is information to help you with such problems and how to report healthcare-related complaints.
California’s health insurance program under the Affordable Care Act is called Covered California.
You may apply online at the Covered California website.
To apply in person, Covered California’s Get Help page has a list of free counselors in your area.
To report problems with a Health Maintenance Organization (HMO), including issues about medical care, prescriptions, preventive testing, and mental health services, contact the Department of Managed Health Care online or by calling their consumer help line: (888) HMO-2219 or (877) 688-9891 (TTY).
If your problem involves a serious or imminent threat to your health, such as the denial of treatment, tell the Department of Managed Health Care that it is an urgent matter.
To report problems with indemnity policies or traditional fee-for-service plans (such as Blue Cross/Blue Shield), contact the California Department of Insurance online or by calling their consumer help line: (800) 927-4357 or (800) 482-4833 (TTY).
To report problems with a Preferred Provider Organization (PPO), including issues of medical care, prescriptions, preventive testing, and mental health services:
To report problems with a self-insured health plan:
Multiple Employer Welfare Arrangements (MEWAs) permit employer members of trade, industry, professional, and other associations to create trust funds for the purpose of offering health care benefits to employees. Only MEWAs issued a certificate of compliance by November 30, 1995, from the California Department of Insurance are allowed to operate in the state.
Report complaints about MEWAs to the California Department of Insurance online or by calling their consumer help line: (800) 927-4357 or (800) 482-4833 (TTY).
To report problems with dentists, registered dental assistants, and registered dental hygienists, contact the Board of Dental Examiners.
To report problems with medical doctors, registered dispensing opticians, spectacle lens dispensers, contact lens dispensers, licensed midwives, and research psychoanalysts, contact the California Medical Board online or by phone at (800) 633-2322 (toll-free).
If your doctor is an osteopathic doctor, contact the Osteopathic Medical Board of California online or by calling them at (916) 928-8390.