There’s a new resource for beneficiaries enrolled in Cal MediConnect: the Cal MediConnect Ombudsman Program. Now, 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.
Reach Ombudsman services Mon – Fri, 9 a.m. – 5 p.m., by calling (855) 501-3077 (TTY 1-855-847-7914).
You can also visit their website at www.healthconsumer.org.
For more information,
- read a sample Integrated Denial Notice on your options if your plan denies a claim
- Read the fact sheet on Rights & Responsibilities
- Visit our Ombudsman Resources section.
Other resources for help
If you need help understanding your 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.
CCI county offices
Non-CCI county offices
Los Angeles County
Neighborhood Legal Services of Los Angeles County
Legal Aid Society of Orange County
2101 N. Tustin Avenue
Santa Ana, CA 92705
San Diego County
Legal Aid Society of San Diego
Consumer Center for Health Education & Advocacy
1764 San Diego Avenue, Suite 200
San Diego, CA 92110
San Mateo County
Legal Aid Society of San Mateo County
330 Twin Dolphin Drive, Suite 123
Redwood City, CA 94065
*Appointments are to be made in advance
Santa Clara County
Bay Area Legal Aid
4 N. Second Street, Suite 600
San Jose, CA 95113
1735 Telegraph Avenue
Oakland, CA 94612
Contra Costa County
1025 Macdonald Avenue
Richmond, CA 94801
30 North San Pedro Road, Suite 170
San Rafael, CA 94903
San Francisco County
1035 Market Street, 6th Floor
San Francisco, CA 94103