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Members

Member Rights & Responsibilities

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Your Rights


Molina Healthcare members have these rights:

  • To be treated with respect, giving due consideration to your right to privacy and the need to maintain confidentiality of your medical information.
  • To be provided with information about the plan, its services, including Covered Services, its practitioners and providers and member rights and responsibilities.
  • To be able to choose a primary care provider within the Contractor’s network.
  • To participate in decision making regarding your own health care, including the right to refuse treatment.
  • To voice grievances or appeals, either verbally or in writing, about the organization or the care received.
  • To receive care coordination.
  • To request an appeal of decisions to deny, defer, or limit services or benefits.
  • To receive oral interpretation services for their language.
  • To receive free legal help at your local legal aid office or other groups.
  • To formulate advance directives.
  • To have access to family planning services, Federally Qualified Health Centers, Indian Health Service Facilities, sexually transmitted disease services and Emergency Services outside the Contractor’s network pursuant to the federal law.
  • To request a State Hearing, including information on the circumstances under which an expedited hearing is possible.
  • To have access to, and where legally appropriate, receive copies of, amend or correct your Medical Record.
  • To disenroll upon request. Beneficiaries that can request expedited disenrollment include, but are not limited to, beneficiaries receiving services under the Foster Care, or Adoption Assistance Programs; and members with special health care needs.
  • To access Minor Consent Services.
  • To receive written member informing materials in alternative formats (including braille, large-size print, and audio format) upon request and in a timely fashion appropriate for the format being requested and in accordance with W & I Code Section 14182 (b)(12).
  • To make recommendations regarding the organization’s member rights and responsibilities policy.
  • To be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation.
  • To receive information on available and appropriate treatment options and alternatives, presented in a manner appropriate to your condition and ability to understand, regardless of cost or benefit coverage.
  • To receive a copy of your protected health information, and request that they be amended or corrected, as specified in 45 CFR §164.524 and 164.526.
  • Freedom to exercise these rights without adversely affecting how you are treated by the Contractor, providers or the State.

Your Responsibilities


Molina Healthcare members have these responsibilities:

  • To supply information (to the extent possible) that the organization and its practitioners and providers need in order to provide care.
  • To follow plans and instructions for care that they have agreed to with their practitioners.
  • To understand their health problems and participate in developing mutually agreed-upon treatment goals, to the degree possible.

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