We want to give you good care!
Molina Healthcare works with our providers to give you good health care. We look at your Member benefits and make choices about health care based on what you need. We want you to know:
- We do not reward providers to deny care.
- We do not reward staff or other people to deny care or give you less care.
- We do not pay extra money to providers or our staff Members to deny tests or treatments that you need to get better or stay healthy.
See your primary care provider (PCP) for a health checkup. Many people wait until they are sick to see a provider. You do not need to wait. Make sure you schedule a checkup before you get sick. This will help keep you well.
A PCP can handle most health care needs. But sometimes there are special problems such as a broken bone or heart disease. A visit to a provider who has extra training may be needed. This provider is called a specialist. If you need to see a specialist, your PCP will make sure you see the right one and may be able to help you get an appointment faster.
Women's Health Care Provider
Women may self-refer to a Women's Health Care Provider (WHCP) and have a WHCP in addition to a PCP. Women may change their WHCP at any time.
If you are away from Molina Healthcare’s service area and need emergency care, go to the nearest emergency room for care. Please contact Molina Healthcare Member Services within 24 hours or when medically reasonable to notify us of urgent or emergent care you received. Call toll-free (855) 687-7861. If you are deaf or hard of hearing, call the national TTY line toll-free 7-1-1. When you are away from Molina Healthcare’s service area, only urgent or emergency care is covered.
No services are covered for members outside the United States.
If a Molina Healthcare provider is unable to provide a member with necessary and covered services, Molina Healthcare must cover the needed services through an out-of-network provider. The cost to members should be no greater than it would be if the provider were in Molina Healthcare’s network. This must be done in a timely manner for as long as Molina Healthcare is unable to provide the service.
Sometimes you get ill after hours.
- If you can, wait until the next day when your PCP’s office is open.
- You can also call our Nurse Advice Line toll-free. Our nurses can help you any time of the day or night. They will tell you what to do or where to go to be seen.
It is best to ask your PCP ahead of time about what to do for care after hours. Ask your PCP the name of a nearby urgent care center or hospital you can go to. It is best to find out ahead of time. Ask your PCP the name of the urgent care center and hospital you can use.
Urgent care is treatment needed right away, but your life is not in danger. Urgent care services are available when you are within or outside of Molina Healthcare’s service area. However, no services outside the United States are covered.
Emergency care is available 24 hours a day, 7 days a week for Molina Healthcare members.