Filing a Grievance

A grievance is a formal way of telling us that you are unhappy about the quality of care you’ve received, waiting times and the customer service you receive. Clever Care is committed to protecting the health care rights of members, including the right to file a grievance. The grievance process helps ensure members get needed health care services.

Members are encouraged to report grievances so the plan can address them and improve.

Grievance and Appeal Forms

Available in five languages (all updated 03/12/2026):

• Grievance and Appeal Form in English (updated 03/12/2026)
• Grievance and Appeal Form in Chinese (updated 03/12/2026)
• Grievance and Appeal Form in Korean (updated 03/12/2026)
• Grievance and Appeal Form in Vietnamese (updated 03/12/2026)
• Grievance and Appeal Form in Spanish (updated 03/12/2026)

Filing Deadline

Members must file within 60 days of the event. Those with a valid reason for late filing should notify Clever Care, which will consider whether to extend the timeline for filing a complaint/grievance.

How to File a Complaint/Grievance

Call Customer Service at 1-833-283-9888 (TTY: 711)

Fax to 1-657-276-4715

Mail to:
Clever Care
Attn: Grievance and Appeals
7711 Center Avenue, Suite 100
Huntington Beach, CA 92647

Chapter 9 of the Evidence of Coverage contains additional process details. Members can also visit Medicare.gov.

For process or status questions, or to get aggregate grievance, appeal, and exception numbers, members can call Customer Service at 1-833-283-9888 (TTY: 711).

This page was last updated on March 19, 2026.