Below is the breakdown of service areas between the two Michigan plans offered by Molina Healthcare:
Molina Medicare Complete Care (HMO SNP) H5926-001 – Allegan, Arenac, Barry, Bay, Clare, Genesee, Gratiot, Huron, Kent, Lake, Lapeer, Livingston, Macomb, Mason, Mecosta, Monroe, Montcalm, Muskegon, Newaygo, Oakland, Oceana, Osceola, Ottawa, Saginaw, Sanilac, Shiawassee, Tuscola, Washtenaw, Wayne
Molina Medicare Complete Care (HMO SNP) H5926-004 – Antrim, Branch, Charlevoix, Crawford, Grand Traverse, Kalkaska, Leelanau, Manistee, Missaukee, Otsego, Roscommon, Wexford
Annual Notice of Change
The Annual Notice of Changes (ANOC) is a brief summary of benefits and benefit changes to your plan. For a more comprehensive description of your benefits, please refer to the Evidence of Coverage (EOC) which can also be found on this page.
Evidence of Coverage (EOC)
The information in this booklet is in effect from January 1, 2021 through December 31, 2021.
The EOC, along with your enrollment form, is Molina's contract with you. These documents explain your rights, benefits, and responsibilities as a member of Molina Medicare. They also explain our responsibilities to you, as well as outline the following details:
- What is covered and what is not covered.
- How to get the care you need, including rules you must follow.
- What you pay for your health plan.
- Your rights as a member of our plan, including treatment decisions and using advance directives.
- What to do if you are unhappy about something related to getting your covered services.
- Our responsibility to treat patients with dignity, fairness and respect.
- How to disenroll from Molina Medicare and other options that are available.
- Your rights and responsibilities upon disenrollment. Please refer to Chapter 10 of the EOC above for details.
- A list of Out-of-Network Coverage Rules.
If you would like to receive this booklet in a different format or language, please contact Member Services.
*Printed copies of information posted on our website are available upon request.
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