Frequently Asked Questions
1.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.
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2.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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3.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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4.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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5.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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6.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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7.What if I need a dentist?
Dental care is covered by your DSHS Medical ID Card (Coupon). Call DSHS at 1-800-562-3022 if you have questions about dental care.
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8.What if I need Vision Care?
Except for some members in group practices (see note below), Molina Healthcare uses a company named March Vision Care for routine eye exams. You can go to a March Vision Care provider without a referral from your PCP. Call March Vision Care at 1-888-493-4070 to find a March Vision Care provider near you, or visit them on the web at http://www.marchvisioncare.com
NOTE: If your Molina Healthcare ID card has NPN or WVMC next to your PCP's name, your PCP is part of a group practice. Contact your PCP for a list of eye doctors in that group practice.
Eyeglasses and eyeglass fittings are covered by your DSHS Medical ID Card (Coupon). Call DSHS at 1-800-562-3022if you have questions about eye care.
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9.What if I need help getting to my medical appointments?
If you need help getting to and from your provider’s office, call the Medical Assistance Customer Service Center (MACSC) at 1-800-562-3022. You can also call the broker in the link below for your area.
If you are hearing impaired, call (TTY/TDD) 1-800-848-5429. For more information, go to the MAA website at http://fortress.wa.gov/dshs/maa/transportation/phone.htm
A broker in your area will try to arrange transportation for you. This may be by public bus, taxi, cabulance, commercial bus, air, gas vouchers, client and volunteer mileage reimbursement or non-profit group. This service is at no cost to you.
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10.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
- Most equipment and medical supplies
- X-ray tests like MRI or CT scans
- Visits to a provider who does not have a contract with Molina Healthcare
- 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.
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11.What do I do if I am out of my service area and I need to see a doctor?