Appeals and Grievances

Many issues or concerns can be promptly resolved by our Member Services Department. If you have not already done so, you may want to first contact Member Services before submitting one of the forms below.

Health Net encourages you to provide a detailed account of your experience. Your feedback is important to us and we appreciate the time you have taken to share this information. We hope that you will allow us to continue to serve you and provide the excellent service that you deserve.

If you believe a delay in the decision making may impose an imminent and serious threat to your health, please contact Member Services using the toll-free telephone number on your ID card to request an expedited review.

Log in to access one of the following forms:

  • APPEAL FORM
    Use this form when appealing the denial of a service or benefit. It will be submitted to the Appeals and Grievances Department for review.
  • GRIEVANCE FORM
    Use this form to formally express your dissatisfaction with care or service(s) you've received. It will be submitted to the Appeals and Grievances Department for review.
  • MEMBER SERVICES FORM
    Members may use this form to communicate directly with our Member Services Department via email.