Annual Notice of Change (ANOC)

duals_eoc_p

This document outlines the changes in your benefits and services for the new contract year starting January 1.

icon PDF 2022 Molina Dual Options Cal MediConnect ANOC (Riverside, San Bernardino and San Diego)

icon PDF 2022 Molina Dual Options Cal MediConnect ANOC (Los Angeles)

Member Handbook

The information in this booklet is in effect from January 1, 2022 through December 31, 2022.

icon PDF 2022 Molina Dual Options Cal MediConnect Member Handbook (Riverside, San Bernardino and San Diego)

icon PDF 2022 Molina Dual Options Cal MediConnect Member Handbook (Los Angeles)

The Member Handbook is part of our contract with you. This document explains your rights, benefits, and responsibilities as a member of Molina Dual Options. This also explains our responsibilities to you, as well as outline the following details:

  • What is covered and what is not covered.
  • How to get the care you need, including rules you must follow.
  • What you pay for your health plan.
  • Your rights as a member of our plan, including treatment decisions and using advance directives.
  • What to do if you are unhappy about something related to getting your covered services.
  • Our responsibility to treat patients with dignity, fairness and respect.
  • How to disenroll from Molina Dual Options and other options that are available.
  • Your rights and responsibilities upon disenrollment - for more information, please see Chapter 8 of the Member Handbook .
  • A list of Out-of-Network Coverage Rules.

  

Molina Dual Options Cal MediConnect Plan Medicare-Medicaid Plan is a health plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees.

You can get this information for free in other formats, such as large print, braille, or audio. Call (855) 665-4627, TTY/TDD: 711, Monday – Friday, 8 a.m. to 8 p.m., local time. The call is free.

Limitations and restrictions may apply. For more information, call Molina Dual Options Cal MediConnect Plan Medicare-Medicaid Plan Member Services or read the Molina Dual Options Member Handbook.

Benefits and/or copayments may change on January 1 of each year.

The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. We will send you a notice before we make a change that affects you.

Molina Healthcare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-855-665-4627 (TTY: 711).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-855-665-4627 (TTY: 711).

注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-855-665-4627(TTY:711).

PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-855-665-4627 (TTY: 711).

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-855-665-4627 (TTY: 711).

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-855-665-4627 (TTY: 711) 번으로 전화해 주십시오.

ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-855-665-4627 (телетайп: 711).

ՈՒՇԱԴՐՈՒԹՅՈՒՆ՝ Եթե խոսում եք հայերեն, ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ: Զանգահարեք 1-855-665-4627 (TTY (հեռատիպ)՝ 711):

ប្រយ័ត្ន៖ បើសិនជាអ្នកនិយាយ ភាសាខ្មែរ, សេវាជំនួយផ្នែកភាសា ដោយមិនគិតឈ្នួល គឺអាចមានសំរាប់បំរើអ្នក។ ចូរ ទូរស័ព្ទ 1-855-665-4627 (TTY: 711)។

توجه: اگر به زبان فارسی گفتگو می کنید، تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با 1-855-665-4627 (TTY: 711) تماس بگیرید.

ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصلبرقم 1-855-665-4627 (رقم هاتف الصم والبكم: 117).

 

 

Plan Materials

English  |  ភាសាខ្មែរ  |  فارسی   |  한국어  |  русский  |  中文  |  Հայերեն  |  Tagalog  |  Español  |  việt  |   العربية  |    

 *Printed copies of information posted on our website are available upon request.

icon PDF Adobe Acrobat Reader is required to view the file(s) above. Download a free version.