Complaints Process for HMOs
If you have any complaints or issues with your HMO, please call the California Department of Managed Health Care's (DMHC) HMO Help Center at:
888-HMO-2219
TDD: 877-688-9891
or visit the DMCH website at www.dmhc.ca.gov
If your health problem is urgent, or if you already filed a complaint and are not satisfied with your health plan's decision, contact the HMO Help Center at the DMHC. An urgent problem is a serious threat to your health. You can also file a complaint with the HMO Help Center if your HMO does not make a decision within 30 days.
The HMO Help Center will assist you with your complaint. They will also provide you with an Independent Medical Review (IMR), if you qualify.
Filing a Complaint
You may file a complaint with the DMCH HMO Help Center if:
  • Your problem is urgent and waiting to finish your health plan's complaint (grievance) process will be a serious risk to your health.
  • You have not received a decision from your health plan within 30 days, or within 3 days if your problem is urgent.
  • You are not satisfied with your health plan's decision.
How to File a Complaint
To file an urgent complaint, call the HMO Help Center.
To file a complaint that is not urgent, visit the DHMC website and fill out and mail a Complaint Form.
There is no charge for your call. The HMO Help Center is open 24 hours a day, 7 days a week and can provide help in many languages. You may also email your complaint/problem by using the special contact form on the CMHC website.