HMO Guide for Seniors - Office of the Patient Advocate - State of ...

61
Questions & Answers
I am not happy with the care
I received, and I feel that my
HMO did not listen to my
concerns.
Call HSAG. HSAG helps
Medicare members with
complaints about quality
of care.
I can’t get a doctor or
interpreter who speaks my
language. What can I do?
First call your HMO. If
that does not help, you can
file a grievance.
I have had several problems
with my doctor. My HMO
hasn’t been very helpful either.
Remember, you can change
your doctor if you want. Or
you can change to another
Medicare Advantage plan
or Original Medicare. See
pages 10–11.
things you can do
For Help and Information
Call your HMO. You may be able to solve your
problem with a phone call.
Ask your HMO for information on grievances.
Look in your HMO’s Evidence of Coverage or plan
handbook.
For help with grievances, call HICAP.
For more information on grievances, visit
www.cahealthadvocates.org.
Speak Up for Yourself
Take notes when you have a phone call or meeting.
Note the date and time, and the names of people
you talk to.
If the person you talk to isn’t helpful, ask to speak
to a supervisor.
If different people tell you different things about
the services you can get, ask to speak to a
supervisor.
Have someone with you for extra support.
If you are told that you can’t have the care you
want, ask for the reason in writing.
where to find help
California Health Advocates
Information on Medicare
www.cahealthadvocates.org
HICAP (Health Insurance Counseling & Advocacy)
Free information and assistance with grievances
1-800-434-0222 www.aging.ca.gov/hicap
HSAG (Health Services Advisory Group)
Help with complaints about quality of care
1-866-800-8749 www.hsag.com