Members

Grievance & Appeals

Member Grievance and Appeals

As a Molina Healthcare of Nebraska member, if you have a problem with your medical care or Molina's services, You have a right to file a grievance or appeal. A grievance can be filed when you are unhappy with your care. Some examples are:

  • The care you get from your PCP.
  • The time it takes to get an appointment or be seen by your PCP.
  • The providers you can choose for care.
  • You believe our notices and other written materials are difficult to understand.
  • Failure to give you a decision within the required timeframe.

An appeal can be filed when you do not agree with Molina Healthcare of Nebraska’s decision to:

  1. Stop, suspend, reduce, or deny a service.
  2. Deny payment for services provided.

If you are not satisfied with the results of your appeal, you may request a State Fair Hearing. A DHHS Hearing Officer will review your case, and you will have the opportunity to present evidence at the hearing. For more information on how to file a grievance, appeal, or State Fair Hearings please click on the links below. We are here to help you! Contact Member Services. 

  1. How to file a grievance
  2. How to file an appeal
  3. Request a State Fair Hearing

*You may request printed copies of all content posted on our website.

You may have to pay for services that are not covered. You may also have to pay for services from providers not part of our network. If the services were an emergency, you don’t have to pay. If you need help, call Member Services.