What does Molina cover?

You deserve the right care, at the right time, and with the right provider.

As a Molina member, you get medically necessary Medicaid-covered services at no cost to you! You also get extra benefits from Molina, which you can read about in the Your Extra Benefits booklet.

The list below includes some services Molina covers. For a full list of covered services, read the Covered Services List or visit the What’s Covered section of our website.

Health equity exists when everyone has the opportunity to be as healthy as possible. Molina is committed to advancing health equity and providing high-quality health care for all our members. Everyone deserves to feel their best and have equitable access to quality care, services, and resources. Molina is dedicated to reducing health disparities (avoidable differences in health) and removing barriers that prevent you from your best health.

Physical healthcare

Molina covers health services like:

  • Primary care provider (PCP) services, including well exams, preventive care and screenings, immunizations (shots), and pregnancy tests.
  • Routine dental cleanings and exams.
  • Annual eye exam, including lenses and frames.
  • Specialist services, including consultation, diagnosis, and treatment.
  • Urgent care.
  • Emergency services.

 

Getting routine preventive care and screenings is important to keep you healthy and prevent future health problems. You should see a doctor once a year for a well visit and as needed for health concerns. Find a doctor that helps you feel comfortable and safe. Talk to friends about providers they use and like, or use the resources here. Click here for more information on talking to your provider about being LGBTQ+.

Mental healthcare

People in the LGBTQ+* community are at a higher risk for having a mental health condition, especially depression and anxiety disorders1. This is due to social and cultural impacts that negatively affect LGBTQ+ people’s mental health.

Molina covers mental health services like:

  • Evaluation, diagnosis, and assessment.
  • Treatment and counseling.
  • Crisis intervention.
  • Substance use disorder treatment services.


Sexual healthcare

Molina Medicaid covers:

  • Exams and medical treatment for family planning and sexual health.
  • Lab and diagnostic tests.
  • Family planning methods (birth control pills, patch, ring, IUD, injections, implants).
  • Supplies (condom, foam, film, diaphragm, cap).
  • Treatment for sexually transmitted infections (STIs).
  • PrEP (pre-exposure prophylaxis).


Gender-affirming care

Molina covers the following gender-affirming care services:

  • Hormone therapy.
  • Puberty blocking agents.
  • Speech therapy to match gender identity.
  • Mental health and counseling services.
  • Surgical services.

 

Molina may need prior approval for some types of services. Some services may have age limits or require previous completed services. Molina covers surgical services for gender-affirming care such as the treatment of gender dysphoria. If you’re looking for specific types of gender-affirming care, speak with your doctor.

For more info about services Molina covers, check out the Covered Services List at MolinaHealthcare.com/OHMedicaidHandbook.

About prior approval (prior authorization)

Your provider may need to ask Molina to approve some treatments and services before you can get them. This is called “prior approval (PA).” It is also sometimes called “prior authorization.”

You can get most services without PA. However, some services do require it.

If a service requires PA, Molina Healthcare’s medical staff and your doctor review the medical need of your care before the service is given. They will make sure it is the right type of care for your health condition.

Click here to view the list of services that need prior approval.

About Molina’s provider network

Remember, you must get covered, medically necessary services from health centers and providers in Molina’s network. These providers agree to work with Molina to give you needed care.

You can find providers in Molina’s network by searching at MolinaProviderDirectory.com/OH.

Your Member Handbook

Your Member Handbook tells you what you need to know about your Molina Medicaid health plan. Read it at MolinaHealthcare.com/OHMedicaidHandbook.

Questions?

Call Member Services at (800) 642-4168, TTY 711, 7 a.m. to 8 p.m. Eastern Time, Monday through Friday, to learn more.


*Lesbian, gay, bisexual, transgender, queer (LGBTQ).

**National Alliance on Mental Illness (NAMI).