Select your State and Language
Find out if you can become a member of the Molina family. Pick your state and your preferred language to continue.
Cookies
We use cookies on our website. By using our website, you consent to our use of cookies in accordance with our Privacy Policy. Read more
Find helpful resources, plan materials, payment information and more. Enter a query above to search our website.
Categories
Email this page
Thank You!
Your message has been sent.
Unable to send email, contact IT Support Team
Select your plan to look up covered drugs
Please note that these links will take you to an external website.
Select your plan year to find a pharmacy
Thank you!
Tell Us what You Think..
We appreciate your feedback about our website.
Rate This Page
Overall Satisfaction with this Website
Ease of Use
Information
Almost Thereā¦ Let us help you enroll today!
We've received your information and a representative will be in touch with you shortly.
{80692560-8A36-43CB-8836-C57F3A6E0584}
Unable to process request temporarily
*This is a solicitation for insurance and an agent may contact you.
By providing your email address, you are opting to receive health plan information and marketing email communications. You can unsubscribe at any time.
The Availity Essentials portal provides access to all portal functions.
Getting Started
Make a Payment
Forms and Documents
When can you Enroll?
FAQ
2024 Marketplace Provider Manual
2023 Marketplace Provider Manual
Prior Authorization LookUp Tool
Behavioral Health Prior Authorization Form
Behavioral Health Therapy Prior Authorization Form (Autism)
Complex Case Management - External CM Referral Form
MCG Cite AutoAuth Provider Access Quick Resource Guide
Q2 2024 PA Code Matrix
Q1 2024 PA Code Matrix
Q4 2023 PA Code Matrix
Q3 2023 PA Code Matrix
Q2 2023 PA Code Matrix
Q1 2023 PA Code Matrix
Q4 2022 PA Code Matrix
Q3 2022 PA Code Matrix
Q2 2022 PA Code Matrix
Q1 2022 PA Code Matrix
Q4 2021 PA Code Matrix
Q3 2021 PA Code Matrix
Q2 2021 PA Code Matrix
Q1 2021 PA Code Matrix
Q4 2020 PA Code Matrix
Q3 2020 PA Code Matrix
Q2 2020 PA Code Matrix
Q1 2020 PA Code Matrix
Q4 2019 PA Code Matrix
Q3 2019 PA Code Matrix
Q2 2019 PA Code Matrix
Q1 2019 PA Code Matrix
Q4 2018 PA Code Matrix
Q3 2018 PA Code Matrix
Q2 2018 PA Code Matrix
Q1 2018 PA Code Matrix
Prior Authorization 2024 Guide
Prior Authorization 2023 Guide
Prior Authorization 2022 Guide
Prior Authorization 2021 Guide
Prior Authorization 2020 Guide v2
Prior Authorization 2020 Guide
Prior Authorization 2019 Guide
Prior Authorization 2018 Guide
Provider Dispute Resolution Request Form
No Surprises Act - Independent Dispute Resolution Form (Non-Contracted Providers only)
Prescription Drug Prior Authorization Request Form
Medical Benefit (HCPCS/J-Code) Drug Prior Authorization Form
Certificate of Medical Necessity-Enteral Nutrition
Provider Information Data Form
Member Grievance Form (English)
Member Grievance Form (Spanish)
Allowed In-Office Lab Test List, effective 5-15-2018
Health Education Referral Form
Health Management Services Flyer in English (for Members only)
Health Management Services Flyer in Spanish (for Members only)
Health Management Services Flyer in Arabic (for Members only)
Health Management Services Flyer in Vietnamese (for Members only)
Health Education Services Provider Resources Flyer (for Providers only)