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We are Here for You
Whether you need a new ID card or the answer to a question about medical coverage—you have a team you can lean on. Your On Lok PACE care team is available to talk about your care, provide information, and discuss any concerns. And let us know how we are doing—your satisfaction is very important to us.
Your PACE participant rights
Your safety and comfort as an On Lok PACE participant is our upmost concern. We care about our participants, and we want to make sure you receive quality healthcare and support services, in a caring and supportive environment that values your dignity and independence. For more information about your rights and responsibilities as a PACE participant, please see the On Lok PACE Participant Bill of Rights in your preferred language below.
English | Chinese | Spanish | Vietnamese | Hindi
Your satisfaction is very important to us
As a participant of the On Lok PACE program, it is your right to voice your concerns and file a complaint at any time, without fear of reprisal from staff. In order to better serve you, we have grouped concerns and dissatisfaction into two categories:
On Lok PACE considers a “grievance” as any complaint, either written or oral, that expresses dissatisfaction with how we deliver our services or the quality of care that we provide. For information about how to file a grievance, please read the On Lok PACE Information for Participants about the Grievance Process in your preferred language below.
English | Chinese | Spanish | Vietnamese | Hindi
When On Lok PACE decides not to cover or pay for a service you want, you may take action to change our decision. The action you take—whether verbally or in writing—is called an “appeal.” For information about how to file an appeal, please read the On Lok PACE Information for Participants about the Appeals Process in your preferred language below.
English | Chinese | Spanish | Vietnamese | Hindi
You can file a grievance or an appeal using one of the following options:
Online
To access our online form, please click the button below.
In person or by mail
Please print and complete a grievance or appeals form, below, and deliver it in person or by mail to our Health Plan Services Department at:
On Lok PACE Health Plan Services Department 1333 Bush Street San Francisco, CA 94109
Grievance Form: English | Chinese | Spanish | Vietnamese | Hindi
Appeals Form: English | Chinese | Spanish | Vietnamese | Hindi
By telephone, fax, or e-mail
You can call, fax, or e-mail our Health Plan Services Department to submit a grievance or an appeal.
Telephone: 415-292-8895
Toll-Free: 1-888-996-6565 (TTY: 711)
Fax: 415-292-8745
E-mail: memberservices@onlok.org
After you submit a grievance or an appeal, our Health Plan Services Department will contact you for information.
For more information about the grievance and appeals processes, you can also contact:
California Department of Managed Health Care Help Center 980 Ninth Street, Suite 500 Sacramento, CA 95814-2725 Telephone: 1-888-466-2219 TDD: 1-877-688-9891 Website: http://www.dmhc.ca.gov
Appointment of Representative
You can appoint a representative to act on your behalf to file a grievance or an appeal for you. The individual may be a family member, caregiver, friend, or anyone else you trust to act on your behalf. To name an individual, complete the appropriate Appointment of Representative Form for Medicare or the Appointment of Representative Form for Medi-Cal.
PACE program terms and conditions
The Member Enrollment Agreement Terms and Conditions is the detailed description of your plan benefits. It explains your rights and the rules that you need to follow to get covered services and prescription drugs. To view the On Lok PACE Member Enrollment Agreement Terms and Conditions, please select your preferred language below.
English | Chinese | Spanish | Vietnamese | Hindi
Questions? Contact us.
Please feel free to call us at 415-292-8895 or toll-free at 1-888-996-6565 (TTY: 711), Monday through Friday from 8:00 a.m. to 4:30 p.m. You can also e-mail us at memberservices@onlok.org. We welcome the opportunity to assist you.