Access for Infants and Mothers Program Banner

The Department of Health Care Services (DHCS) Benefits Appeal Process

You should first attempt to resolve disputes with the plan according to its established policies and procedures. If you are dissatisfied with the resolution of your grievance you can appeal to the California Department of Health Care Services (DHCS).

The benefit appeal must be submitted to DHCS in writing within sixty (60) calendar days following the Plan’s decision. The appeal must include the following:

  • A copy of any decision being appealed or a written statement of the action or failure to act being appealed;
  • A statement specifically describing the issue you are disputing;
  • A statement of the resolution you are requesting; and
  • Any other relevant information you would like to include.

Appeals that do not include the above information will be returned. You may resubmit the complete appeal within the sixty (60) calendar days from the plan’s denial or within twenty (20) calendar days of the receipt of the returned appeal, whichever is later. Mail or FAX your appeal to:

Executive Director - Benefits Appeal
Department of Health Care Services
Medi-Cal Eligibility Division
Medi-Cal Access Program Unit
1501 Capitol Avenue MS 4607
P.O. Box 997417
Sacramento, CA 95899-7417
(916) 552-9200-Public
Fax: (916) 552-9478