The Summary of Benefits outlines your plan premium, benefits, copayments and coinsurance for the current calendar year.
Please click on the link below to find out about the plan benefits.
2018 Molina Medicare Options (HMO) Summary of Benefits
The Provider & Pharmacy Directory outlines your plan's network of Primary Care Physicians, Specialists, Hospitals, Skilled Nursing Facilities, Outpatient Facilities, Pharmacies and Supplemental Provider contacts.
Provider Online Directory Search
If you would like to request a printed copy of this directory, please call Member Services or email us at CentralizedOps.Medicare@MolinaHealthcare.com
Supplemental Dental Online search
Supplemental Vision Online search
Supplemental Hearing Online search
You must receive your care from a network provider
In most cases, care you receive from an out-of-network provider (a provider who is not part of our plan's network) will not be covered. Here are three exceptions:
- The plan covers emergency care or urgently needed care that you get from an out-of-network provider. For more information about this, and to see what emergency or urgently needed care means, see the Evidence of Coverage Chapter 3.
- If you need medical care that Medicare requires our plan to cover and the providers in our network cannot provide this care, you can get this care from an out-of-network provider. In this care prior authorization is required. Please contact Member Services. If you obtain routine care from out-of-network providers without prior authorization, neither Medicare nor the Plan will be responsible for the costs. In this situation, we will cover these services as if you got the care from a network provider.
- Kidney dialysis services that you get at a Medicare-certified dialysis facility when you are temporarily outside the plan's service area.
How to get care from out-of-network providers
If you need medical care that Medicare requires our plan to cover and the providers in our Network cannot provider this care; you can get this care from an out-of-network provider. In this case a prior authorization is required. If you obtain routine from out-of-network providers without prior authorization, neither Medicare nor the Plan will be responsible for the costs.
*Printed copies of information posted on our website are available upon request.
Over-the-Counter (OTC) Benefit
Your Plan includes a supplemental Part C OTC benefit.
2018 OTC Benefit
In 2018 you will still have a supplemental Part C OTC benefit but the vendor, order process, and OTC Product Catalog will change.
For 2018 we have partnered with Convey Health to bring this special Plan benefit to you at no cost. Simply order online, call (866) 420-4010; (TTY 711), Monday to Friday 8 AM to 8 PM, ET, or mail your completed order form. Your order will be shipped directly to your door.
Click on this link OTC Product Catalog (PDF) (Coming Soon) to view the list of OTC products you may need and for information on how to place your OTC order in 2018.
Adobe Acrobat Reader is required to view the file(s) above. a free version.