| Who can I call with questions, concerns or complaints? |
| You can call Molina Healthcare Member Services Monday through Friday, 7:30 a.m. to 5:30 p.m. Our number is 1-800-869-7165. (Hearing impaired: 1-877-665-4629)
You can also call the 24-hour Nurse Advise line at 1-800-564-8329 to get answers to your health questions at any time. return to the top
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| Can I change my Primary Care Provider (PCP)? |
Yes. You can change your PCP by calling Molina Healthcare Member Services at 1-800-869-7165. Most changes will take place the 1st of the month following your request.
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| Why do I need a Primary Care Provider (PCP)? |
Having a Primary Care Provider gives you a medical home. Your PCP manages your care, provides you services, and refers you to specialists.
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| 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.
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| Who is eligible to enroll with Molina Healthcare? |
If you are eligible for one of the programs listed here, you are most likely eligible to enroll in Molina Healthcare.
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| How can I enroll with Molina Healthcare? |
If you are eligible for one of the programs listed here, you are most likely eligible to enroll in Molina Healthcare.
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| What if I need a dentist? |
Basic Health does not cover Dental Care.
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| What if I need Vision Care? |
Basic Health does not cover routine/annual eye exams unless done by the PCP as part of a routine preventive care examination. If you have an eye problem or injury, specialty care is covered like any other specialty care.
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| How can I get specialty care? |
| Your PCP must approve all your specialty care (except women's health care). If you think you need specialty care, contact your PCP. If your PCP thinks you need specialty care, your PCP will refer you to a specialist who has a contract with Molina Healthcare.
In some cases, your PCP or the specialist you are seeing will need to call Molina Healthcare and request we approve specialty care or services. This request for approval should be done before treatments or tests take place. Here is a list of some tests and treatments that require prior approval:
Cancer care from oncology providers
Oxygen
X-ray tests like MRI or CT scans
Visits to a provider who does not have a contract with Molina Healthcare
Chiropractic (self-refer or may be referred by PCP)
Hospital care and most surgeries
We give all PCPs frequent updated lists of what needs prior approval. If you are not sure what needs to be approved, call Member Services at 1-800-869-7165 or call your PCP. If a request for specialty care is denied by Molina Healthcare, you or your PCP can appeal our decision.
If you want to know about a specialist's medical training, board certification, etc., call Member Services at 1-800-869-7165 and we will get you the information.
If you need to see a specialist for a non-urgent visit, it may take up to one month to get an appointment. If your PCP will not refer you, call Member Services at 1-800-869-7165. return to the top
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| What do I do if I am out of my service area and I need to see a doctor? |
If you are out of your home service area, Molina Healthcare covers you for emergent care. Routine care is not covered outside of your service area.
- Emergency Care is care for a sudden or severe health problem, including severe pain that needs care right away. It can also be care that is needed because you believe your health is in serious jeopardy and without care your injury may result in serious impairment to bodily functions or serious dysfunction of a bodily organ, or part. Emergency care is covered. If you need emergency care, call 911 or go to the nearest hospital. If you are not sure if something is an emergency, you can also call the 24-hour Nurse Advise line at 1-800-564-8329for health care advice.
- Routine Care is pre-planned care such as a regular provider visit or pre-planned surgery. Routine Care must be from your PCP, or other provider, who has a contract with Molina Healthcare. Routine care is not covered outside your service area. If you need routine care while out of the area, call the 24-hour Nurse Advise Line at 1-800-564-8329 for health care advice.
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