Your Rights and Responsibilities

If you have questions or need help with your health care, please call our Customer Service Department at 1-714-246-8500 or toll free at 1-888-587-8088 Monday through Friday from 8 a.m. to 5:30 p.m. Pacific Time. Members with hearing or speech impairments can call our TDD/TTY line at 1-714-246-8523. We also provide interpreter services at no cost to our members. We have staff who speak your language.

Your Rights As A CalOptima Member

At CalOptima, our goal is to provide you with the highest quality care possible. To us, quality care means more than having great health care providers. It means making sure you understand your benefits and know your rights as a CalOptima member. It also means working together with us to improve our programs and services. And, in case you ever have concerns about the health care services you get, it is important to us that you understand where to
get help.

Your Rights and Responsibilities

As a CalOptima member, you have rights and responsibilities. These are the standards we promise to you and your responsibilities as a member in turn.

Your Right To Privacy

CalOptima has a privacy policy that explains the steps we take to keep your personal information private. It also describes how and when we might share your health information with others.

You Can Report Fraud
Or Abuse

If you see any activity that you think is fraudulent or wasteful, we strongly encourage you to call our Compliance and Ethics Hotline at 1-877-837-4417 or report the activity using the Suspected Fraud or Abuse Referral Form. You do not have to give your name to report fraudulent activity.

You Can File A Grievance Or Complaint

In case you ever have concerns about the health care services you get, you have the right to file a grievance or complaint. CalOptima will not discriminate against you or limit your benefits in any way if you report concerns or file a complaint.

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