Your Member Handbook
Please read your Member Handbook. It also includes your "Certificate of Coverage and Disclosure Form" or your "COC". It tells you:
- About your health plan
- About your benefits and what is covered
- How to get the services you need, including special health care needs
- How to contact us
- Your rights and responsibilities as a member
Read your Member Handbook today
This information tells you which services need approval before you get care and shows how many requests are approved, denied, or approved after an appeal. It also shows how fast decisions are made for regular and urgent requests, even when more time is needed to review them.
Need your Member Handbook in a different language or format?
Call Member Services at (888) 898-7969, Monday - Friday, 8 a.m. to 5 p.m. EST (TTY: 711) to request a copy of the member handbook free of charge. You may ask for it in braille, large print or audio. If you are hearing or sight impaired, special help can be provided.
What if I need transportation?
If you need a ride to your appointments, Molina is here to help. Schedule a free ride to medical appointments.
Please call Transportation Member Services 24 hours a day, 7 days a week at
(888) 898-7969 for more information and to schedule a ride or request mileage reimbursement. It is important to call 3 days in advance of your appointment to schedule a ride.
CMS-0057 Prior Authorization Annual Reporting
This report shows how prior authorization requests are handled, such as how many were approved or denied and how quickly decisions were made. To find out if a specific service needs prior authorization, members and providers should check the plan’s Prior Authorization Guide or use the Prior Authorization Lookup Tool.
Prior Authorization Guide 2025
Prior Authorization Lookup Tool
Michigan Medicaid Prior Authorization Annual Report 2025
| Prior Authorization Statistics |
How many times this happened |
Out of total requests |
Molina Healthcare Inc
Percentage
|
| The percentage of STANDARD prior authorization requests that were approved, aggregated for all items and services. |
64979 |
76552 |
85% |
| The percentage of STANDARD prior authorization requests that were denied, aggregated for all items and services. |
11573 |
76552 |
15% |
| The percentage of STANDARD prior authorization requests that were approved after an appeal, aggregated for all items and services. |
324 |
647 |
50% |
| The percentage of EXPEDITED prior authorization requests that were approved after an appeal, aggregated for all items and services. |
70 |
171 |
41% |
| The percentage of STANDARD prior authorization requests for which the review timeframe was extended, and the request was approved, aggregated for all items and services. |
189 |
283 |
67% |
| The percentage of EXPEDITED prior authorization requests for which the review timeframe was extended, and the request was approved, aggregated for all items and services. |
43 |
58 |
74% |
| The percentage of EXPEDITED prior authorization requests that were approved, aggregated for all items and services. |
8990 |
10278 |
87% |
| The percentage of EXPEDITED prior authorization requests that were denied, aggregated for all items and services. |
1288 |
10278 |
13% |
| Percentage of total prior authorization requests approved with extended timeframe |
|
|
|
|
Timing |
| Average time that elapsed between the submission of a request and a determination by the payor, plan or issuer, for STANDARD prior authorizations, aggregated for all items and services. (Measured in days) |
6 |
| Median time that elapsed between the submission of a request and a determination by the payor, plan, issuer, for STANDARD prior authorizations, aggregated for all items and services. (Measured in days) |
6 |
| Average time that elapsed between the submission of a request and a decision by the payor, plan or issuer, for EXPEDITED prior authorizations, aggregated for all items and services. (Measured in hours) |
22 |
| Median time that elapsed between the submission of a request and a decision by the payor, plan, issuer, for EXPEDITED prior authorizations, aggregated for all items and services. (Measured in hours) |
22 |
|
Total number of requests |
| Total STANDARD prior authorizations requests received |
76552 |
| Total EXPEDITED prior authorization requests received |
10278 |
| Total STANDARD and EXPEDITED prior authorization requests received |
86830 |
|
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Medicaid Member Handbook and COC