Member Materials and Forms

AHCCCS Drug Lists

Lists of all drugs that are on the AHCCCS Acute and Long-Term Care Drug List.

icon_pdf AHCCCS Acute and Long-Term Care Drug List (Effective October 1, 2022)

Molina Drug List

Molina’s list of covered drugs.

icon_pdf Molina Drug List

Visit the searchable formulary to see if your medication is covered.

Molina Member Handbook

Your Molina member handbook will help you understand your AHCCCS Complete Care (ACC) benefits and how you can get help from Molina.

icon_pdf Molina English Member Handbook -- updated October 2023

Molina Member Newsletters

icon_pdf Member Newsletter - NCQA Guide to Getting Quality Health Care Spring 2023

icon_pdf Member Newsletter Fall 2022

icon_pdf Member Newsletter Spring 2022

icon_pdf Member Newsletter - NCQA Guide to Getting Quality Health Care Spring 2022

icon_pdf Member Newsletter Fall 2021

icon_pdf Member Newsletter Spring 2021

icon_pdf Fall 2019

icon_pdf Spring/Summer 2019

Molina’s Provider and Pharmacy Directories

icon_pdf Molina Provider Directory (English)
icon_pdf Molina Provider Directory (Spanish) 

Molina Autism Spectrum Disorder (ASD) Provider Directory

A list of Molina network providers who can provide services specific to the needs of members with ASD. You can also find these providers using the search filter “Autism Services”.

icon_pdf Molina Autism Spectrum Disorder (ASD) Provider Directory

Molina Opioid Use Disorder (OUD) and Medication-Assisted Treatment (MAT) Provider Directory

A list of Molina OUD and MAT network providers.

icon_pdf Molina OUD and MAT Provider Directory 

Molina Prior Authorization Code List

A complete list of Molina prior authorization codes.

icon_pdf Prior Authorization Code List

Molina Consent to Release Protected Health Information (PHI) Form

This is a form allowing Molina to share PHI with people you have allowed us to.

icon_pdf Molina English Consent to Release Protected Health Information (PHI) Form 

Molina Member Advisory Committee (MAC) Application

Molina's MAC brings our members, their family members and our community partners together to help improve the services and benefits Molina provides. MAC members share advice, ideas and suggestions for changes that will give our Molina members better health care services and Medicaid benefits.

Together, we can make it easier for our Molina members to get the care they need, when they need it. Apply today to join the MAC!

icon_pdf Molina English Member Advisory Committee (MAC) Application

 


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