Member Rights

• To receive all the services that Molina Healthcare must provide.
• To be treated with respect and with regard for your dignity and privacy.
• To be sure that your medical record information will be kept private.
• To be given information about your health. This information may also be available to someone who you have legally okayed to have the information or who you have said should be reached in an emergency when it is not in the best interest of your health to give it to you.
• To be able to take part in decisions about your health care unless it is not in your best interest.
• To get information on any medical care treatment, given in a way that you can follow.
• To be sure that others cannot hear or see you when you are getting medical care.
• To be free from any form of restraint or seclusion used as a means of force, discipline, ease, or revenge as specified in Federal regulations.
• To be able to say yes or no to having any information about you given out unless Molina has to by law
• To ask, and get a copy of your medical records, and to be able to ask that the record be changed/corrected if needed.
• To be able to say yes or no to having any information about you given out unless Molina Healthcare has to by law.
• To be able to say no to treatment or therapy. If you say no, the doctor or Molina Healthcare must talk to you about what could happen and they must put a note in your medical record about it.
• To be able to file an appeal, a grievance (complaint) or state hearing. See pages 34 and 35 of this Handbook for information.
• To be able to get all Molina Healthcare written member information from Molina Healthcare:
• To be able to get help free of charge from Molina Healthcare and its providers if you do not speak English or need help in understanding information.
• To be able to get help with sign language if you are hearing impaired.
• To be told if the health care provider is a student and to be able to refuse his/her care.
• To be told of any experimental care and to be able to refuse to be part of the care.
• To make advance directives (a living will). See page 20, which explains about advance directives. You can also contact Molina Healthcare Member Services for more information.
• To file any complaint about not following your advance directives with the Ohio Department of Health.
• To change your Primary Care Physician (PCP) to another PCP on Molina Healthcare’s panel at least monthly. Molina Healthcare must send you something in writing that says who the new PCP is by the date of the change.
• To be free to carry out your rights and know that Molina Healthcare, its providers or ODJFS will not hold this against you.
• To know that Molina Healthcare must follow all federal and state laws and other laws about privacy that apply.
• To choose the provider that gives you care whenever possible and appropriate. If you are a female, to be able to go to a women’s health provider on Molina Healthcare’s panel for covered women’s health services.
• To be able to get a second opinion from a qualified provider on Molina Healthcare’s plan. If a qualified provider is not able to see you, Molina Healthcare must set up a visit with a provider not on our panel.
• To get information about Molina Healthcare from us.
• To contact the United States Department of Health and Human Services Office of Civil Rights and/or the Ohio Department of Job and Family Services Bureau of Civil Rights at the addresses listed below with any complaint of discrimination based on race, color, religion, sex, sexual orientation, age, disability, national origin, veteran’s status, ancestry, health status, or need for health services.
  
  Office of Civil Rights
  United States Department of Health and Human Services
  233 N. Michigan Ave., Suite 240
  Chicago, Illinois 60601
  1-312-886-2359 1-312-353-5693 TTY
  
  Bureau of Civil Rights
  Ohio Department of Job and Family Services
  30 East Broad Street, 37th Floor
  Columbus, Ohio 43215-3414
  1-614-644-2703, 1-866-227-6353
  1-866-221-6700 TTY
  
  
• To receive information about Molina Healthcare, its services, its practitioners and providers and members' rights and responsibilities.
• To a candid discussion of appropriate or medically necessary treatment options for your conditions, regardless of cost or benefit coverage. To voice grievances (complaints) or appeals about Molina Healthcare or the services it provides.
• To make recommendations about Molina Healthcare's member rights and responsibilities policies.

Member Responsibilities

• Learn and ask questions about your health benefits. If you have a question about your child's benefits, call Molina Healthcare Member Services.
• Give information to your doctor or Molina Healthcare that is needed to care for you and your family.
• Be active in decisions about your health care.
• Follow the care plan that you have agreed on with your doctor.
• Keep appointments and be on time.
• If you are going to be late or cannot keep the appointment, call your PCP.
• Report any fraud or wrongdoing to Molina Healthcare or the proper authorities.
• Be aware of services that are not covered by Medicaid. If you have questions about coverage, call Molina Healthcare Member Services.
• Inform Molina Healthcare and your county caseworker of any change of address, telephone or any changes to entitlement that could affect continuing eligibility.
• To understand your health problems and participate in developing mutually agreed-upon treatment goals to the degree possible.

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