How to file a complaint, grievance or appeal
You have the right to file a complaint, grievance or appeal about:
- Sutter Health | Aetna
- Your plan
- A health care service, provider or professional
You may mail or fax your information by printing the following form:
Member Complaint and Appeal Form
Get help from your state
Your state insurance office can help you if you don’t agree with a decision made by your health plan or if you decide to appeal a decision.
- Choose the state you live in if your medical plan is self-funded.
- Choose the contract state if your medical plan is insured.
If you are not sure, ask your employer or call the toll-free number on the back of your medical plan ID card to find out which type of plan you have.
Get help from the federal government
The Health Care Reform law includes rules about appeals. Many plans have to follow these rules. If your plan is covered by the law, contact the Employee Benefits Security Administration (EBSA) at 1-866-444-EBSA (3272) for help with an appeal.
Living outside the United States?
You may have a medical plan that covers you or your family while you’re living outside the United States. If it's subject to the U.S. health care reform law, choose the state where the plan sponsor has its main place of business. Call the toll-free number on the back of your medical plan ID card if you're not sure.
Our Collaboration
We’re a healthcare company that brings together Sutter Health’s network of nationally recognized, high-quality† doctors and hospitals with Aetna’s leading health plan expertise, cutting-edge data, analytics and health information technology, and shared care management capabilities. Together we bring a performance network†† to market with a goal to deliver a differentiated and personalized experience for members, designed to improve efficiency and lower the cost of care.
Great care, great value, always there for Northern Californians.
†Many of the hospitals and physician organizations in the Sutter Health network have been recognized for quality achievements from The Joint Commission, The Leapfrog Group®, Integrated Healthcare and APG. ††Performance network refers to a network of providers who are clinically integrated.