Type Size:
We use cookies on our website. Cookies are used to improve the use of our website and analytic purposes. By using our website, you consent to our use of cookies in accordance with our Privacy Policy. Read more . I agree
Members

Help with your Medicaid Forms

​​Do you need assistance completing your Medicaid forms to determine your eligibility?

Once a year, the Michigan Department of Health and Human Services requires that you complete new paperwork related to your enrollment and eligibility for Medicaid. You should receive these forms in the mail from your Case Worker about 60 days before they are due.

Once you receive them, just complete the forms and return to your Case Worker by the due date.

Need help completing your forms?

We can help. Just call Member Services Monday - Friday, 8 a.m. to 5 p.m. Molina has representatives who speak your language available to speak with you.

Or you can call your worker using the number listed on the top of the form.

Did you lose your form?

You can get a copy of a new form online by visiting:
https://www.michigan.gov/mdhhs/0,5885,7-339-71551_7338---,00.html

Have other questions?

Please reach out to Molina Healthcare of Michigan’s Member Services team Monday - Friday, 8 a.m. to 5 p.m. We’re always happy to help! ​​​​​​

You are leaving the Molina Medicare product webpages and going to Molina’s non-Medicare web pages. Click Ok to continue.

This link will take you away from the Dual Options section of MolinaHealthcare.com

You are about to leave the Molina healthcare website. Click Ok to continue.

This link will take you away from the Dual Options section of MolinaHealthcare.com

You are leaving the Molina Medicare product webpages and going to Molina’s non-Medicare web pages. Click Ok to continue.

You are leaving the Molina Healthcare website. Are you sure?

This information is for Doctors and
Health Care Professionals only.

X Please wait. Michigan info is loading. Cancel