Questions & Answers

qna

Q. How do I get medical services? 
A. You should get all health care from Molina Healthcare providers. Your Provider Directory lists all the providers that are part of the plan. If you need a printed copy, call Member Services. It also lists other places you can go.

You can get the care you need from your Primary Care Provider (PCP). Your PCP can help you with the following:

  • Checkups
  • Tests and results
  • Shots
  • Illnesses
  • Specialist visits
  • Hospital visits

 

Your PCP name, phone number and address are located on your Member ID Card. If you need help, call Member Services.

You may also see these providers for physical exams and preventive care:

  • Federal Qualified Health Centers
  • Rural Health Clinics
  • County Health Departments

Q. How do I change my provider?
A. If for any reason you want to change your PCP, you must first call Member Services and ask for a new PCP. You can change your PCP at any time.

  • Each member of your family can have a different PCP or you can pick the same PCP for the entire family.
  • You will be sent a new Member ID Card. The Member ID Card will have the new PCP’s name, phone number and address.

If your PCP has changed, call your new doctor to fill out a Medical Records Release Form. This will help your new doctor get your medical records from your previous doctor. The form is in your Membership Welcome Packet. If you need a copy of the form, call Member Services.

Q. How do I get translation services?
A. If you prefer to speak in your own language, Member Services can help. There is no cost to you. Call Member Services. If you are hard of hearing, call our TTY line. An interpreter will be available to speak with you. If you have an appointment, your doctor can help you find an interpreter. They can also help you speak to the doctor. An interpreter can help you:

  • Make an appointment.
  • Talk with your doctor or nurse.
  • Get emergency care.
  • File a complaint, grievance or appeal.
  • Get help from a pharmacist about taking medicine.

Q. What is an authorization?
A. When an approval is needed, it is called a “prior authorization”. Your PCP will take care of any referrals or authorizations you need.

Q. Who can I call with questions, concerns or complaints?
A. Our Member Services team can help you. Our staff is bilingual and can answer any questions that you may have about your health plan benefits.

Q. How does Molina Healthcare look at new services?
A. Molina uses a medical review process to rate:

  • A new drug
  • Medical device
  • Medical rule or procedure
  • Surgical rule or procedure
  • Behavioral health rule or procedure
  • Therapy

We want to make sure that it is safe for sure. We also want to know if it is good for a medical symptom or condition. It is compared to cures. The goals of this process are:

  • To review and update coverage choices as new scientific proofs are found.
  • To review cases in order to decide if it is a certain service we should cover or not.

Molina Healthcare may deny a drug, device, protocol, procedure or other therapy that is new. We might say it is not medically necessary. If this happens, you can ask us why. You or your doctor can ask for this information. You can have copies of all the rules and procedures we used to make the decision. For information on this process, call Member Services.

Q. How do I get behavioral health services?
A. We can help you get behavioral health services. We can also find you help for drug and alcohol abuse. Call Member Services at 1-866-472-4585.

Q. When do I get my new Member Handbook and Member ID Card?
A. You can request your Member Handbook by calling Member Services or online www.MyMolina.com. Your Molina Healthcare Member ID Card should be sent to you in the first week after your enrollment is effective with Molina Healthcare of Florida.

Q. What if I need vision care?
A. As a member of Molina Healthcare, your vision care is provided to you by iCare.

If you need vision care, you must go to a doctor that is part of the iCare Health Solutions. To find a vision care center close to you, please call the Molina's Member Services Department.

Q. How can I get specialty care?
A. Your PCP will take care of most of your needs. There will be times when you will need to see other type of doctors for medical problems like special conditions, injuries, or illnesses. These doctors are called specialists. You would have to talk to your PCP first. Your PCP will refer you to a specialist.

  • Cardiologist
  • ENTs (Ear, Nose & Throat)
  • Neurologist
  • Allergists

There are some providers that do need referrals. For example:

  • Gynecologist
  • Dermatologist
  • Psychologist

It is a good idea to check with Member Services if the doctor is part of Molina Healthcare. If you need a provider that is not part of Molina Healthcare, call your PCP to get prior approval from Molina.

Q. What if my doctor sends me for lab tests?
A. Your doctor will be sending your lab tests to Quest Diagnostics. If you need to take a lab test outside of your physician’s office, please go to Quest Diagnostics. To find a location near you, please call (866) MyQuest (866-697-8378) or you can go to www.QuestDiagnostics.com.

Q. How do I make an appointment?
A. You should see your PCP within 90 days of your enrollment or sooner. You should be able to get an appointment with your PCP or a specialist as follows:

  • Urgent Care – within two (2) days
  • Non-Urgent Care- within one (1) month for PCP and two (2) months for a specialist 
  • Routine Sick Care – within (1) week
  • Well Care – within (1) month

Please contact us if you cannot get an appointment when you need one. You may call Member Services for help.

Q. How do I join Molina Healthcare?
A. If you qualify for Medicaid and want to become a member, call Choice Counseling at 1-877-711-3662, TDD 1-866-467-4970, Monday through Thursday from 8 a.m. to 8 p.m.; Friday from 8 a.m. to 7 p.m.

Q. What drugs are covered? Are my drugs covered?
A. To find out what drugs are covered under Molina Healthcare of Florida’s Medicaid Health Plan, view the Preferred Drug List (PDL) here

Q. What kind of transportation do I get? I need help with transportation.
A. Go to “What’s Covered” and you will find information about transportation under “Services”. You can also call Member Services at (866) 472-4585.

Q. How do I find out if a health care service or benefit is covered?
A. Go to “What’s Covered” to find out about benefits and services. You can also call Member Services at (866) 472-4585.

 

Medicaid Service Area

*Region 8 Counties: Charlotte, Collier, De Soto, Glades, Hendry, Lee, Sarasota

 

*Region 11 Counties: Miami-Dade, Monroe

 

*Molina Healthcare is a Managed Care Plan with a Florida Medicaid contract. The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the Managed Care Plan. Limitations, co-payments, and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change.

For Medicaid:

If you have difficulty in reading or understanding this information, please contact Molina Healthcare Member Services toll free at (866) 472-4585, TTY at 711 for help. This information can be provided orally in English, or in your primary language. Written translations may be available in certain languages and accommodations will be made for the visually impaired.


Please note: If you have a disability and need more help, we can help you. If you need someone that speaks your language, we can also help. You may call our Member Services Department at 1-866-472-4585 for more help from 8:00 a.m to 7:00 p.m. If you are blind or have trouble hearing or communicating, please call 711 for TTY/TTD services. We can help you get the information you need in large print, audio (sound), and braille. We provide you with these services for free.


Tenga en cuenta lo siguiente: Si tiene una discapacidad y necesita más ayuda, podemos ayudarlo. Si necesita una persona que hable su idioma, también podemos ayudarlo. Puede llamar a nuestro Departamento de Servicios para Miembros al 1-866- 472-4585 para recibir más ayuda, de 8:00 a. m. a 7:00 p. m. Si es ciego o tiene problemas de audición o para comunicarse, llame al 711 para servicios de TTY/TTD. Podemos ayudarlo a obtener la información que necesita en letra grande, audio (sonido) y braille. Le brindamos estos servicios en forma gratuita.


Veuillez noter: Si vous avez un handicap et vous avez besoin plus d'aide, nous pouvons vous aider. Si vous avez besoin de quelqu'un qui parle votre langue, nous pouvons vous aider aussi. Vous pouvez appeler le Service aux Membres au 1-866- 472-4585 entre 8:00 a.m. et 7:00 p.m pour obtenir plus d'assistance. Si vous êtes aveugle ou si vous avez des problèmes auditifs, veuillez appeler 711 pour les services TTY/ATS. Nous pouvons vous aider à trouver l'information dont vous avez besoin en gros caractères, audio (son), et braille. Nous vous fournissons ces services gratuits.


Nota: siamo in grado di offrire ulteriore assistenza agli associati con disabilità. Ove necessario, è possibile richiedere l’intervento di un addetto che parli la lingua dell’associato. Per ulteriori informazioni è possibile chiamare il nostro Dipartimento dei servizi per gli associati (Member Services Department) al numero 1-866-472-4585 dalle ore 8:00 alle 19:00. Gli associati non vedenti, ipovedenti, non udenti o con difficoltà di comunicazione possono usufruire dei servizi TTY/TTD (trasmissione telefonica di testo/dispositivi di telecomunicazione per non udenti) resi disponibili tramite il numero 711. Siamo in grado di fornire le informazioni necessarie in formato di stampa a caratteri grandi, in formato audio (sonoro) e braille. Questi servizi sono fruibili gratuitamente.


Veuillez noter : si vous avez un handicap et besoin d’une aide supplémentaire, nous pouvons vous aider. Si vous avez besoin de quelqu’un qui parle votre langue, nous pouvons aussi vous aider. Vous pouvez appeler notre département de services aux membres au 1-866-472-4585 pour une aide supplémentaire de 8h00 à 19h00. Si vous êtes aveugle ou avez des troubles de l’audition ou de la communication, veuillez téléphoner au 711 pour les services de télécommunication à l’intention des malentendants. Nous pouvons vous aider à obtenir les informations dont vous avez besoin en grands caractères, sous forme audio (sonore) et en braille. Nous fournissons ces services gratuitement.


Обратите внимание: Мы помогаем лицам с ограниченными способностями или тем, кому требуется дополнительная помощь. Если вам требуется лицо, говорящее на вашем языке, мы также можем помочь. Для получения дополнительной информации вы можете связаться с отделом обслуживания участников программы по телефону 1-866-472-4585 с 08:00 до 19:00. Если у вас есть нарушения зрения, слуха или речи, позвоните по номеру 711 для связи по телетайпу/текстовому телефону. Мы можем предоставить вам необходимую информацию крупным шрифтом, в аудиоформате или шрифтом Брайля. Данные услуги предоставляются бесплатно.


Spanish
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-472-4585 (TTY: 711).


French Creole
ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. (Haitian Creole) Rele 1-866-472-4585 (TTY: 711).


Vietnamese
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-866-472-4585 (TTY: 711).


Portuguese
ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-866-472-4585 (TTY: 711).


Chinese
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 1-866-472-4585(TTY:711)。


French
ATTENTION: Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-866-472-4585 (TTY : 711).


Tagalog
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-866-472-4585 (TTY: 711).


Russian
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-866-472-4585 (телетайп: 711).


Arabic
ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم 1-866-472-4585 رقم.(711( :والبكم الصم ھ


Italian
ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-866-472-4585 (TTY: 711).


German
ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-866-472-4585 (TTY: 711).


Korean
주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-866-472-4585 (TTY: 711) 번으로 전화해 주십시오.


Polish
UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 1-866-472-4585 (TTY: 711).


Gujarati
સચુ ના: જો તમે ગજુ રાતી બોલતા હો, તો નન:શલ્ુ ક ભાષા સહાય સેવાઓ તમારા માટે ઉપલબ્ધ છે. ફોન કરો 1-866-472-4585 (TTY: 711).


Thai
เรียน: ถ้าคุณพูดภาษาไทยคุณสามารถใช้บริการช่วยเหลือทางภาษาได้ฟรี โทร 1-866-472- 4585 (TTY: 711).