After you enroll, Molina Dual Options will send you a Member Handbook and a Molina Member ID card. The handbook has a lot of information about your benefits. As your new health plan, we will make sure your care continues and is not disrupted. Molina Dual Options will work with you and your doctors to make sure you get all the care you need.
If you have a scheduled treatment and just joined Molina Dual Options, call Member Services. Tell us about your treatment so we can work with you.
Continuing Care With Your Doctors
You may continue to see your physician or receive services that were authorized before you joined Molina Dual Options for a period of 6 months for Medicare services and 12 months for Medi-Cal services to allow Molina time to attempt to contract with your provider. This time period is determined by CMS or your state.
You still must call Molina Member Services before you receive the care. If you do not call us, you may not be able to receive the care or the claim may not be paid. For example, call Member Services if you have the following services already authorized or scheduled:
- Organ, bone marrow or hematopoietic stem cell transplant
- Third trimester prenatal (pregnancy) care, including delivery
- Inpatient/outpatient surgery
- Appointment with a primary or specialty provider
- Chemotherapy or radiation treatments
- Treatment following discharge from the hospital in the last 30 days
- Non-routine dental or vision care (for example, braces or surgery)
- Medical equipment
- Services you receive at home, including home health, therapies, and nursing
- Long Term Services and Supports (LTSS)
- Pregnancy through Postpartum services or longer period as necessary for safe transfer to another provider
After the time period determined by CMS or your state, you must get all your covered services from providers who work with Molina Dual Options. These are "in-network" providers. Your doctor must agree to work with Molina Dual Options.
Once you join Molina Dual Options, we will tell you if any of your current medications require prior authorization (PA) that did not require authorization before you joined Molina Dual Options. You will be allowed to received up to a 31-day temporary supply of your medications that require prior authorization within the first 90 days of your membership in the plan while we review your prior authorization requests. If you live in a long-term care facility, you can receive up to a 93-day temporary supply of these medications within the first 90 days of your membership in the plan. It is very important that you look at the information we provide and contact Member Services if you have any questions.
Our website lists the medication(s) that require prior authorization. You may need to ask your prescribing provider's office to submit a prior authorization, you cannot get the medication(s) until your provider submits a request to Molina Dual Options and it is approved.
If you have any questions, you can call Member Services.