The Medi-Cal office of the Ombudsman helps solve problems from a neutral standpoint to ensure members receive all medically necessary covered services for which plans are contractually responsible.

The Ombudsman will not automatically take sides in a complaint. All sides are considered in an impartial and objective way. It is thier job to help develop fair solutions to health care access problems.

The Office of the Ombudsman:

• Serves as an objective resource to resolve issues between Medi-Cal managed care members and managed care health plans.
• Conducts impartial investigations of member complaints about managed care health plans.
• Helps members with urgent enrollment and disenrollment problems.
• Offers information and refererrals.
• Identifies ways to improve the effectiveness of the Medi-Cal managed care program.
• Educates members on how to effectively navigate through the Medi-Cal managed care system.

Web pages

• Office of the Ombudsman - https://www.dhcs.ca.gov/services/medi-cal/Pages/MMCDOfficeoftheOmbudsman.aspx