Appeal my Medi-cal decision
If Medi-Cal denies coverage for something your child needs, you are entitled to an appeal. Choose the step-by-step guide(s) that applies to your situation.
Why
You don't have to accept the first "no" you hear. Make sure to review your options for appeal.
Guides
Curated by our research team, signed off by experts and parents alike, guides walk you through the entire process, step-by-step. They cover common pitfalls and how to navigate complexities in order to accomplish your goal.
If your child’s application for Medi-Cal coverage is denied, or if Medi-Cal wants to terminate your existing coverage, this guide walks you through filing a state hearing.
If you disagree with Medi-Cal over medical necessity, coverage, providers, access to care, etc., this guide walks you through filing a grievance with your managed care plan.
If you have filed a grievance with your managed care plan and disagree with the outcome, you can request an independent medical review or consumer complaint.
If you disagree with a Medi-Cal Notice of Action, you can request a state hearing (sometimes also called a fair hearing).
Work smarter with the personalized support of a Navigator
Feeling overwhelmed? We can help you create a plan and find your people.A Navigator will:
- Help you prioritize goals and tasks, including ones you may not know existed
- Design a customized roadmap to meet your goals and support you at every turn
- Connect you to the resources and services your child needs in less time
Resources
While guides offer a step-by-step approach, suggested resources provide more detailed context so you can dive into a topic. Bookmark resources you want to refer back to by starting your free library.
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Appeal my Medi-cal decision
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