Molina Healthcare FAQs

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FAQs

We Want to Give You Good Care!

Molina Healthcare works with your providers and hospitals to give you good health care. We make choices about your care based on what you need. We also look at your benefits. We do not reward providers to deny you care. We also do not reward staff or other people to deny you care or give you less care. We do not pay extra money to providers or our staff members to deny tests or treatments that you need to get better or stay healthy.

You may call our Member Services team if you ever have a concern about your health care. Our staff is here to take your call Monday through Friday (except holidays) during normal business hours. They can answer questions about how we make health care choices.

Member Services - 1-866-472-4585

We also want to remind you that Molina Healthcare has a Nurse Advice Line to help answer questions you may have about your health. There are nurses ready to help you 24 hours a day, 7 days a week. To speak to a nurse, call the toll-free number below.

English: 1-888-275-8750
1-866-735-2929 (TTY)

Spanish: 1-866-648-3537
1-866-833-4703 (TTY)

1	How do I get medical services?
2	How do I change my provider?
3	How do I obtain interpreter services?
4	What is a referral or authorization?
5	Who can I call with questions, concerns or complaints?
6	How does Molina look at new services?
7	How do I get behavioral health services?
8	When do I get my new member handbook and ID card?
9	What if I need a dentist?
10	What if I need vision care?
11	How can I get specialty care?
12	What if my doctor sends me for lab tests?
13	How do I make an appointment?
14	Who is eligible to enroll with Molina?
15	How do I join Molina?

1. How Do I Get Medical Services? (Choice of Providers and Facilities)

This section tells you where you can go to get health care.You should get all health care from Molina providers. Your Provider Directory lists them all. It also lists other places you can go.

You can get care at some approved offices like:

Health centers
Rural health clinics
Family planning providers. This list is in your Provider Directory
Community mental health centers
Florida Alcohol and Drug Abuse Association offices. These should be Medicaid providers.
In an emergency you can see any provider. It does not need to be a Molina provider.

We update the Provider Directory and mail it to you once a year. It tells you where you can get health care.

2. How do I change my provider?

The provider directory has a list of Molina providers. You can also call Member Services.
Select a new provider and call us. Molina will send you a new ID card with the provider's name. The card also says the effective date of the change.

3. How do I obtain interpreter services?

You have a right to an interpreter. There is no cost to you. Tell the office staff if you would prefer to talk in your own language. If you need help, call Member Services.

4. What is a Referral or Authorization?

A "Referral" means you go somewhere else to for service. Referrals may be written or by phone. Some must be approved by your provider or Molina. This kind is called an “authorization”. Your PCP will take care of any referrals you need.

5. Who can I call with questions, concerns or complaints?

Our Member Services Department is available to assist you. Call us at 1-866-472-4585, Monday through Friday, 8:00 a.m. to 7:00 p.m. Our staff is bilingual and can answer any question that you may have in regards to your health plan benefits.

Molina also has a 24-hour Nurse Advice Line that you may call toll-free at 1-888-275-8750 (English) or 1-866-648-3537 (Spanish). A registered nurse can answer any question you may have regarding your health care.

Please remember that you may also speak to your primary care provider about your medical concerns. Your primary care provider and his/her staff are there to help.

If you need further assistance, you may also contact Molina's Ombudsman Unit at 1-888-665-4621. An Ombudsman is someone who can help you if you are not satisfied with the help you received from Molina Member Services.

6. How does Molina look at new services?

We also look at new services. And we look at new uses for benefits you have now. We review new studies to see if services should be added to your benefit package. Molina Healthcare reviews the type of services listed below at least once a year:

Medical services
Mental health services
Medicines
Equipment

*Printed copies of information posted on our website are available upon request.

7. How do I get behavioral health services?

Molina wants you to have the help you need. We can help you get behavioral health services. We can find you help for drug and alcohol abuse. Call Molina Member Services for information at 1-866-472-4585.

You can access behavioral health services such as:

Providers
Nurses
Psychologists
Social workers

These providers are trained to help you with psychiatric and emotional problems.

Behavioral health services include:

Inpatient
Outpatient hospital services
Psychiatric provider services
Individual, family, and group therapy
Treatment provided by a psychiatrist or behavioral health provider
Social rehabilitation
Day treatment for adults and children
Individual and family assessments
www.psychcare.com

8. When do I get my new member handbook and ID card?

You should receive your Member Handbook and Molina Healthcare ID Card the first or second week after your enrollment is effective with Molina Healthcare.

9. What if I need a dentist?

If you need dental services, you may get care from any dentist who accepts Doral. For the name of the nearest dentist in your area, you may call Doral at 1-888-696-9541. TTY # for Customer Service Helpline at
1-800-466-7566

10. What if I need vision care?

As a member of Molina Healthcare, your vision care is provided to you by March Vision Care. To find the vision care center nearest you, call 1-888-493-4070. You may also visit the March Vision Care website at www.marchvisioncare.com.

11. How can I get specialty care?

You should be able to get an appointment with a Specialist as follows:

Within (30) days for non-urgent care
Within two (2) days for urgent, but care that does not threaten your life. This is care that can be done in a provider’s office

Please contact us if you cannot get an appointment when you need one. Call us at 1-866-472-4585 for help. Don’t forget to bring your State Medicaid card with you to all of your provider’s visits. Also, be sure to bring your Molina Healthcare member ID card with you as well. Please be on time so that you can be seen as scheduled.

12. What if my doctor sends me for lab tests?

Your doctor will be sending your lab tests to Quest Diagnostics. If you need to take a lab test outside of your physician’s office, please go to Quest Diagnostics. To find a location near you, please call 1-866-MyQuest (1-866-697-8378) or you can go to www.Questdiagnostics.com.

13. How do I make an appointment?

You should be able to get an appointment with your Primary Care Provider (PCP) as follows:

Within (30) days for routine, non-urgent care
Within (60) days for school physicals
Within two (2) days for urgent, but care that does not threaten your life. This is care that can be done in a provider’s office

Please contact us if you cannot get an appointment when you need one. Call us at 1-866-472-4585 for help. Don’t forget to bring your State Medicaid card with you to all of your provider’s visits. Also, be sure to bring your Molina Healthcare member ID card with you as well. Please be on time so that you can be seen as scheduled.

14. Who is eligible to enroll with Molina?

Eligible Medicaid Beneficiaries who live in Dade County may join. If you live in this county, but are not sure if you can enroll with Molina, contact Medicaid Options at 1-888-367-6554 or your eligibility worker.

15. How do I join Molina?

If you qualify for Medicaid and want to become a member of Molina call Medicaid Options at 1-888-367-6554.