Non-Discrimination Notification
Molina Healthcare of Wisconsin Medicaid
Molina Healthcare of Wisconsin (Molina) complies with all Federal civil rights laws that relate to healthcare services. Molina offers healthcare services to all members without regard to race, color, national origin, age, disability, or sex. Molina does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. This includes gender identity, pregnancy and sex stereotyping.
To help you talk with us, Molina provides services free of charge:
• Aids and services to people with disabilities
• Skilled sign language interpreters
• Written material in other formats (large print, audio, accessible electronic formats, Braille)
• Language services to people who speak another language or have limited English skills
• Skilled interpreters
• Written material translated in your language
• Material that is simply written in plain language
If you need these services, contact Molina Member Services at (888) 999-2404, TTY: (800) 947-3529 or 711.
If you think that Molina failed to provide these services or treated you differently based on your race, color, national origin, age, disability, or sex, you can file a complaint. You can file a complaint in person, by mail, fax, or email. If you need help writing your complaint, we will help you. Call our Civil Rights Coordinator at
(866) 606-3889. Mail your complaint to:
Civil Rights Coordinator
200 Oceangate
Long Beach, CA 90802
You can also email your complaint to civil.rights@molinahealthcare.com. Or, fax your complaint to
(414) 831-2886.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for
Civil Rights. Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html. You can mail it to:
U.S. Department of Health and Human Services
200 Independence Avenue, SW Room 509F, HHH
Building Washington, D.C. 20201
You can also send it to a website through the Office for Civil Rights Complaint Portal, available at https://
ocrportal.hhs.gov/ocr/portal/lobby.jsf.
If you need help, call 1-800-368-1019; TTY 800-537-7697.
MOLINA HEALTHCARE NOTICE 1557 - WI MEDICAID UPDATED 06.2022
5245865WI0918
Non-Discrimination Notification Tag Line - Section 1557
Molina Healthcare of Wisconsin Medicaid
English ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-888-999-2404 (TTY: 711).
Spanish ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-999-2404 (TTY: 711).
Hmong LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau 1-888-999-2404 (TTY: 711).
Chinese
Laotian
Burmese
Russian
Somali Somali FIIRO GAAR AH: Hadii aad ku hadasho Ingiriisiga, adeega kaalmada luuqada, oo bilaa lacag ah, ayaa kuu diyaar ah. Lahadal 1-888-999-2404 (TTY: 711).
German ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleis- tungen zur Verfügung. Rufnummer: 1-888-999-2404 (TTY: 711).
Arabic
Korean
Vietnamese CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-888-999-2404 (TTY: 711).
Pennsylvanian
Dutch
Wann du Deitsch (Pennsylvania German schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff:
Call 1-888-999-2404 (TTY: 711).
French ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 1-888-999-2404 (TTY : 711).
Polish UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Za- dzwoń pod numer 1-888-999-2404 (TTY: 711).
Hindi
Albanian* KUJDES: Nëse flitni shqip, për ju ka në dispozicion shërbime të asistencës gjuhësore, pa pag- esë. Telefononi në 1-888-999-2404 (TTY: 711).
Tagalog PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tu- long sa wika nang walang bayad. Tumawag sa 1-888-999-2404 (TTY: 711).
Serbo- Croatian
PAŽNJA: Ako govorite srpsko-hrvatski imate pravo na besplatnu jezičnu pomoć. Nazovite
1-888-999-2404 (TTY: 711). 21969FRMMDWIENL MHWI – 1557 tag lines