In light of the rapidly changing health care market, the DMHC wants to make sure consumers are protected from deception or fraudulent marketing practices. As partners helping you navigate through the complex healthcare landscape, the DMHC can help you.
If you believe you have been a victim of Health Insurance Fraud and would like to submit a complaint, please use the Department of Managed Health Care (DMHC) Fraud Complaint form to report false, misleading, or deceptive statements or practices in the marketing and sale of health insurance products. For example, if you were sold, or someone attempted to sell you a fake insurance policy, which was represented as consistent with the Affordable Care Act, also known as Obamacare, but it did not provide any benefits.
Review the DMHC Consumer Alerts about Health Insurance Fraud and the actions that individuals can take to protect themselves.
If you need assistance or have questions contact the DMHC Help Center at 1-888-466-2219.
Steps to Filing
1. Print a Fraud Complaint Form
The Fraud Complaint Form is available in 15 languages. Select the language you want.
2. Complete and sign the form
If you need additional space to complete your answer, please attach a separate page.
3. Include supporting documentation
Include copies of letters or other documents you believe may be relevant to your complaint. Please send copies of documents, not originals. The Help Center cannot return any documents.
4. Mail, fax or email the completed form and supporting documents to:
Department of Managed Health Care
980 9th Street, Suite 500
Sacramento, CA 95814-2725
Be suspicious of uninvited house or telephone calls; anyone who approaches you at a doctor’s office, hospital, or pharmacy; and limited time offers, or claims that there are only a few spots left.
- Don’t pay any money up front to get insurance or Medi-Cal.
- Don’t provide your personal information such as your social security number, bank account number, credit card number, or birth date, unless you make sure you are not dealing with scammers.
- Trust only Covered California or other official government websites.
- Call 1-800-300-1506 to make sure the person you are dealing with is authorized with Covered California.
- When dealing with insurance agents, call the California Department of Insurance at 1-800-927-HELP.
- To report deceptive or suspicious activity, contact: The Help Center, Department of Managed Health Care, at 1-888-466-2219; The Consumer Hotline, Department of Insurance, at 1-800-927-HELP, or Covered California at 1-800-300-1506.
Consumer Alerts about Health Insurance Fraud
In light of the rapidly changing health care market, there is concern that consumers may be preyed upon by deceptive or misleading, and potentially fraudulent, marketing practices. To that end, the DMHC published a Consumer Alert with recommended actions individuals can take to avoid deceptive health care marketing schemes. The alert has been translated into five languages and is available for download and distribution.