Molina offers Disease Management Programs that can help you manage your chronic health conditions. Our programs offer learning materials, advice and care tips. We also help you work with your doctor. The goal is to help you learn to manage your health conditions.
Members are found through medical or pharmacy claims. Members are enrolled in the program(s) that meets their needs. If your health condition is more complex a Nurse Care Manager may call you. The nurse helps you get the care you need. If you have a chronic condition not listed below you may contact us. We will refer you to a Nurse Care Manager for assistance.
There are many ways you can be referred to these programs. One way to enroll is through your doctor. You also can self-refer to the programs. There are certain requirements that you must meet. These programs are voluntary. You can choose to be removed from a program at any time.
Get help managing your chronic illness. Programs include:
Breathe with Ease® (Asthma) Program
This program is for adults with asthma. You will learn:
Healthy Living with Diabetes® program
This program is for adults ages 18 and above living with diabetes. You will learn about:
Heart Healthy Living program
This program is for adults with:
You will learn about:
Living with Chronic Obstructive Pulmonary Disease (COPD) program
This program is for adults with COPD. You will learn:
Health education programs
Molina has various programs and services to offer you. There are many ways you can be referred to a program or service. One way to enroll is through your doctor. You also can self-refer to the program. There are certain requirements that you must meet. You can choose to be removed from these programs at any time. Call us for more information (855) 483-8741.
You can stay healthier when you ask for guided help with:
Smoking Cessation Program
This program is for members who are ready to kick the smoking habit. The program is for smokers who are over 18 years of age. You will be asked about your readiness to stop smoking. If you are ready and have the support to take this important step, you may be eligible to join. The program is done over the phone and lasts for six months.
Weight Control Program
This program is for members who may need help controlling their weight. The weight control program is provided for Molina members. You will learn about healthy eating and exercise. You may go to classes in your area if classes are offered.
Diabetes Prevention Program
Molina Healthcare has partnered with Solera Health to offer a diabetes prevention program.
This program helps match you with support that fits your needs. This program can help you build healthy habits and lower your risk for type 2 diabetes.
The program may include the following:
Visit solera4me.com/molina or call (888) 305-6058 (TTY 711), Monday to Friday 8 a.m. to 8 p.m., local time to see if you pre-qualify.
Women’s Health Care Services
You can get services from any doctor who has a contract with Molina Medicare. You do not need a referral from your main doctor. This may include services such as:
Preventive Health Guidelines
When to Get an Exam
Do you know when you need an exam or other preventive health services? Our Preventive Health Guidelines outline recommended exams and services for you and your family. They provide basic suggestions for healthy children and adults without known medical issues. They should not replace your doctor’s advice.
Do your part to stay healthy!
24-hour Nurse Advice Line
Talk to a nurse anytime, day or night, by calling our 24-hour Nurse Advice Line (844) 794-3638.
Virtual Care
Get expert health care from the comfort of home.
Access virtual care through additional telehealth services – search the Molina Provider Online Directory to find a Primary Care Physician who can provide services online or over the phone at no cost to you.
If at any point your symptoms worsen or you feel like you are experiencing a medical emergency, call 911 or proceed to the nearest emergency room.
Case Management and Complex Case Management
Living with health problems and managing them can be hard. We offer special services and programs for members who need extra help with a health problem.
Case Management is when a nurse works with you and your main doctor. The nurse will help you get the care you need.
Complex Case Management program is for members with difficult health. Both programs allow you to work with a nurse. The nurse can help you learn more about your health problems and how to better manage them.
There are many ways you can be referred to this program. One way to enroll is through your doctor. You also can self-refer to the program by calling Member Services at (855) 483-8741 to see if you meet requirements to participate.
This program is voluntary and is offered at no cost to you. You can choose to be removed from the program at any time.
Care Coordination
Care Coordination helps members with long‑term health needs. This health problem can be either physical or mental.
A Care Coordinator’s job is to:
How can I help my Care Coordinator help me?
Write down your questions. This will help you remember things when you have a lot to talk about.
For more information or if you have questions, call Member Services at (855) 483-8741. If you feel that you need emergency treatment, please get help first or call 911.
Supplemental Dental
Molina Medicare Complete Care (HMO D-SNP)
Original Medicare does not cover preventive dental care like cleanings or X‑rays.
We cover additional dental benefits that Original Medicare does not cover. These benefits are detailed separately below under the Dental services (Supplemental) category.
Supplemental dental services covered include, but not limited to:
Preventive Dental
Comprehensive Dental
Comprehensive dental services are covered up to the annual plan maximum benefit coverage amount:
To find an in-network dental provider close to you can search online – using our supplemental dental provider online search tool at MolinaHealthcare.com/Medicare or call us at (855) 483-8741 (TTY: 711)
Supplemental Vision
Molina Medicare Complete Care (HMO D-SNP)
We have partnered with a Vision Vendor for added value.
Supplemental Vision services covered include, but not limited to:
You can use your eyewear allowance to purchase:
* You may use your eyewear allowance for contacts. You must pay for eyewear that costs more than your allowance.
You pay $0 for one routine eye exam each year. You have an eyewear allowance every calendar year.
To find a vision provider near you:
Search online – using our supplemental vision provider online search tool at MolinaHealthcare.com/Medicare.
Supplemental benefits help pay for items Medicare does not cover. You can use these benefits only during the plan year. You must be enrolled when you get the service.
Supplemental Hearing
Molina Medicare Complete Care (HMO D-SNP)
Silver & Fit fitness program
You can join a local fitness center or get a home fitness kit at no cost. A caregiver may join you to help you feel safe.
Start here https://silverandfit.com or call (877) 427-4711 (TTY: 711) Monday to Friday, 8 a.m. to 6 p.m., local time.
24-Hour Nurse Advice Line
You can call the 24‑hour Nurse Advice Line for help 24 hours a day, 365 days a year. Nurses can look up trusted health information and guide you based on your symptoms.
Call the Nurse Advice Line. You can talk to a nurse in your language about any health problem.
Our call center has been reviewed and approved by a national quality review organization (URAC) since 2007. They will help you 24 hours a day, 7 days a week.
24-hour Nurse Advice Line (844) 794-3638 (TTY: 711)
Over-the-Counter (OTC) Benefit: Pre-funded Debit Card (MyChoice Card)
Molina Medicare Complete Care (HMO D-SNP)
You get a monthly allowance on your MyChoice card. You may use it for approved supplemental benefits such as:
*Eligibility requirements apply
Funds are loaded onto the card each month. Unused allowances do not carry over to the next month. OTC hearing aids are covered and included in the combined OTC allowance.
You can use your pre-funded debit card (MyChoice card):
Visit https://Molina.NationsBenefits.com for information about your MyChoice debit card and for a complete list of benefits and services.
Non-Emergency Medicaid Transportation
Molina Medicare Complete Care (HMO D-SNP)
You get a monthly allowance for transportation. It does not correspond to a set number of “rides”. You can use it to pay for non‑emergency medical rides.
Unused funds do not roll over. You may use your allowance for rides:
Use this allowance only for services not covered by Original Medicare or Medicaid. See MyChoice card section for a full list of services in this combined allowance.
Meals Benefit
Molina Medicare Complete Care (HMO D-SNP)
Special Supplemental Benefits for Chronic Illnesses
Molina Medicare Complete Care (HMO D-SNP)
You get a monthly allowance on your MyChoice card. You may use for supplemental plan benefits such as:
Please see the MyChoice Card section for a complete list of benefits and services. Unused allowance does not carry over to next month.
Members must meet the criteria outlined in Chapter 4 of the Evidence of Coverage.
Plan features
Read your member materials
Review your Summary of Benefits and Evidence of Coverage (EOC) to learn what we cover and what you pay, how to use your benefits and more.