Benefits
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Covered Services
Including MYPAC, inpatient/outpatient care, psychiatric residential treatment facilities and therapeutic and evaluative services
All Medicaid policy restrictions applyFor members with a chronic disease – disease management
$700 maximum per year for members 21 and over. Members under 21 can get additional services if medically necessary and prior authorization is obtained
Limitations may apply based on type of services provided.
All Medicaid policy restrictions applyDental
- Emergency pain relief
- Palliative care
$2,500 maximum per yearDental
- Preventive
- Diagnostic
- Restorative
$2,500 maximum per yearOrthodontia
$4,200 maximum per lifetime per child
Annually
Freestanding or hospital-based center services
All Medicaid policy restrictions apply.
Limited to beneficiaries under 21 years of age.
No Limit
Adults: 1 eye exam and 1 pair of glasses annually
Children: (under age 21) 2 eye exams per year and 2 pair of glasses. EPSDT- eligible members are eligible for more services if determined medically necessary.
Inheritable disease diagnosis
Hearing aids are covered for members under 21 years of age, including cochlear implants
Limited to 25 visits per year. Members under 21 can get additional visits if authorized. Physical therapy and speech therapy visits in the home health setting are not covered through the home health program for beneficiaries age 21 and over.
Inpatient and Outpatient
Inpatient and Outpatient
Requires consent form with authorization request
All Medicaid policy restrictions apply.
To medical appointments, vision exams and pharmacy
Including but not limited to Thallium stress test or nuclear stress test
24-hour nurse advice line: (844) 794-3638
Including Prenatal/Postpartum visits
Inpatient/outpatient setting
All Medicaid policy restrictions apply.
24/7 Personal Care Managers available in clinics
No limit
Subject to qualifying systemic diagnosis
Including postpartum care
5 per month; EPSDT eligible members are eligible for more prescriptions if determined to be medically necessary. 72 hour supply of emergency drugs.
Mammograms, well baby and well child care, regular check-ups, EPSDT services
Physician's Office or Outpatient department of a hospital
Infusion in home setting applies to home health benefit limits
Covered for members 21 and over
Requires properly signed consent form, see Title 23: Medicaid Part 202, Rule 5.3 for more information
Inpatient/Outpatient care
Limited to beneficiaries under 21
Outpatient
Yes, in accordance with Title 23: Medicaid Part 202, Rule 4.2 and 4.3
EPSDT immunizations, flu shots and pneumonia vaccines
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Rewards
During pregnancy, visit your OB/GYN for 6 regular prenatal visits and receive a free Cosco car seat.
After giving birth, visit your doctor within 21-56 days of delivery, get a $25 gift card.
Take kids ages 1-3 and 12-13 to all scheduled checkups to receive a $25 gift card. Kids ages 4-11 attend all scheduled checkups to receive a bike helmet or First Aid Only child ID kit.
Expecting moms who have their First Trimester visit or first visit within 42 days of joining Molina MississippiCAN, and Second Trimester visits as scheduled get a $25 gift card for each visit.
If you qualify, get a $25 gift card for receiving mammogram services as recommended.
Get your yearly diabetic retinal eye exam and lab work and get a $25 gift card.
We will help you get a Safelink Tracfone to use 24/7 that allows communication with a Molina care manager, access to transportation and community organizations, our HealthinHand app for access to covered services and appointment reminders and more, including unlimited text. We can help you fill out an application to obtain a Tracfone. In addition, you may have access to the Weight Watcher™ mobile on-line app for 13 weeks on Tracfone.
Molina distributes fresh vegetables to our members through local churches and community organizations
Molina will enroll eligible members with up to 10 weeks of online Weight WatchersTM service vouchers.
These community health workers assist in navigating the healthcare system and accessing community-based programs that promote healthy development, independent living, and physical and mental well-being for members with chronic illnesses.