Molina Complete Care Member Rewards Program

To help you reach your health goals, Molina Complete Care (MCC) is offering rewards for completing certain health-related activities.

Members can earn gift cards for getting important checkups. Use the forms below to let us know you’ve completed your routine doctor visits. Complete a new form for each visit. [Forms to follow]

Note: Your 2021 MCC rewards may be submitted through January 31, 2022.

Adult Form
Preventive/Ambulatory Care (Ages 20+) [Link to form]

Child, Pre-Teen and Young Adult Forms
Well-Child Visit (Age 15 Months) [Link to form] 
Well-Care Visit (Age 3-21) [Link to form] 

Maternity Form
Prenatal Visit [Link to form] 

Read this flyer (coming soon!) to learn more about the MCC member rewards program.
You can submit the form(s) to us in any of the following ways:

Molina Complete Care
Attn: Quality
5055 E Washington St, Suite 210
Phoenix, AZ 85034

Take a picture of the completed form with your smartphone and email the picture to

(800) 424-9956, Attn: Molina Complete Care quality team

Call us at (800) 424-5891 (TTY/TDD: 711) and give us the information about your visit by phone.

The deadline to submit reward forms for visits completed in 2021 is January 31, 2022. Forms received after the deadline will not be processed.