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Health Net uses cookies. By continuing to use our site, you agree to our Privacy Policy and Terms of Use.
Main Menu
- Our Health Plans show Our Health Plans menu
-
For Members
show For Members menu
-
- Member Login
- Members Overview
- Pay My Bill
- Frequently Asked Questions
- Forms and Brochures
- My Health Pays Program
- Behavioral Health
- Health Support Programs
- Your Wellness
- Flu Vaccine
- Access to Care
- Maternity & Family Planning
- Stay Covered
- Appeals and Grievances
- Tax Information
- Confidential Communication Request
- Interoperability and Patient Access
- Learn More
-
- Pharmacy show Pharmacy menu
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 an appeal or grievance.
Member tip: Check the back of your ID card for your phone contact information.
File a GRIEVANCE FORM – Online
File a GRIEVANCE FORM – Mail or Fax
Ambetter from Health Net Plans
- Ambetter from Health Net Member GRIEVANCE FORM – English (PDF)
- Ambetter from Health Net Member GRIEVANCE FORM – En Español (Spanish) (PDF)
- Ambetter from Health Net Member GRIEVANCE FORM – Chinese (PDF)
- Ambetter from Health Net Member GRIEVANCE FORM – Korean (PDF)
- Ambetter from Health Net Member GRIEVANCE FORM – Vietnamese (PDF)