The subscriber number can be found on your Health Net Insurance card. Please enter the complete ID, including all letters and numbers. All letters must be typed as capital letters.
If you want Health Net to reconsider a decision made about your drug benefits, you can file an appeal.
If you have a complaint not related to your drug coverage, you may file a grievance.
INSTRUCTIONS FOR REQUESTING AN APPEAL OR GRIEVANCE:
An "appeal" is a request to reconsider a previous determination. A member, your physician, or other member representative may file an appeal. The appeal process applies to the denial of a pharmacy claim in whole or partial, or the denial of pharmacy benefits.
A "grievance" is any dissatisfaction related to benefits or contractual issues, such as a denial of services not covered under a member's plan. This may include but is not limited to a payment, a benefit limitation or a service issue.
Health Net encourages you to provide a detailed account of your experience. Your feedback is important to us and we appreciate the time you take to share this information. We hope that you will allow us to continue to serve you and provide the excellent service that you deserve.
If you believe a delay in the decision-making process may impose an imminent and serious threat to your health, contact Customer Service using the toll-free phone number on your ID card to request an expedited review. Otherwise, you may initiate an appeal or grievance by phone, fax or mail using the applicable grievance form located online by logging in and selecting Get Things Done, then Get Forms. Or, submit your request online by selecting Get Things Done, then File a Grievance Form.
Mail the Administrative Grievance Form to:
Health Net Appeals & Grievances Department
PO Box 10348
Van Nuys, CA 91410-0348
Or fax the form to: 818-676-7200
If you have any questions regarding the appeals and grievance process, contact Health Net at the Customer Service number located on your ID card.