Molinalogo

Member Rights

• Receive information about Molina Healthcare and about your rights and responsibilities as a Molina Healthcare Member.
• Be treated with respect and courtesy. Molina Healthcare recognizes your dignity and right to privacy.
• Receive interpreter services at no cost to you.
• Receive medically necessary covered services without regard to race, religion, age, gender, national origin, disability, sexual orientation, medical condition, or stage of illness.
• Receive emergency and/or post stabilization services in and out of your network hospital and not incur liability for payment of these services.
• Receive services at Federally Qualified Health Centers.
• Receive sensitive services, such as mental health care, confidentially.
• Receive services from a women’s health specialist within the network for covered care necessary to provide women’s routine and preventative health care services. This is in addition to your assigned primary care medical home if that source is not a woman’s health specialist.
• Receive information from Molina Healthcare that you can understand.
• Make recommendations about Molina Healthcare’s Members’ rights and responsibilities policies.
• Participate with PCPs in decision making about your own health care.
• Talk with your PCP about your medical condition and appropriate or medically necessary treatment options regardless of the cost or what your benefits are.
• Decide about your care, including the decision to stop treatment or services, or stop participating in health management programs.
• Decide in advance how you want to be cared for if you have a life-threatening illness or injury. This includes developing an Advanced Directive that will be recognized by Molina Healthcare. You may receive information about developing an Advanced Directive from your PCP or network hospital. Additionally, if there are changes in state law regarding Advance Directives, you will be notified as soon as possible, but no later than 90 calendar days after the effective date of change.
• Keep your personal and medical information and records confidential.
• Complain about Molina Healthcare, its providers, or your care. Molina Healthcare will help you with the process. You may appeal decisions made by Molina Healthcare. You have the right to choose someone to represent you during the grievance process.
• Have Molina Healthcare act as your patient advocate.
• Request a second opinion about a medical condition.
• Request a copy of Molina Healthcare non-proprietary clinical and administrative policies and procedures. These may be obtained by contacting the Customer Support Center.
• Request and obtain notices of enrollee rights to request and obtain information pertaining to cultural and linguistic services, procedures for obtaining benefits, enrollee rights and protections, information on grievance and fair hearings procedures, and obtaining out of network services.
• Receive any significant change to your rights at least 30 days before the intended effective date of the change.
• Disenroll from the Sacramento LIHP.

Member Responsibilities

• Cooperate with your health care provider and follow your PCP’s instructions.
• Keep your provider and Department of Human Assistance (DHA) advised of any change in your financial circumstances or of any change in your living arrangements, such as address. Please be aware, if it is learned that you received benefits to which you were not entitled, you may be required to repay the plan.
• Be familiar with and ask questions about your health plan coverage.
• Request interpreter services at least 5 business days before a scheduled appointment.
• Call your PCP or pharmacy at least 3 days before you run out of medicine.
• Call your PCP when you need routine or urgent health care.
• Avoid knowingly spreading disease to others.
• Use Molina Healthcare’s grievance process to file a complaint.
• Understand there are risks in receiving health care and limits to what can be done for you medically.
• Notify Molina Healthcare and your PCP if you want to stop the medical plans and instructions you have agreed on.