Coverage for allergy tests is provided to determine what a person is allergic to. Some common types of allergy testing include Skin tests and Elimination-type tests.
Covered treatments include Immunotherapy (commonly called allergy shots).
Both ground and emergency helicopter ambulance transportation are covered. No prior authorization is required.
Excludes non-emergency medical transportation.
Both inpatient and outpatient behavioral health and/or substance abuse services are covered with a prior authorization. Services include:
- Inpatient Psychiatric Hospital
- Inpatient Psychiatric Services
- Mental Health Outpatient Clinic
- Mental Health Rehabilitative Treatment
- Outpatient Psychiatric
- Residential Treatment Centers (RTC)
- Care Management
- Medication Management
If you need mental health and/or substance abuse services, call the Nurse Advice Line for information at (833) 685-2104, TTY/TDD 711 for the hearing impaired.
You may also self-refer directly to a State Certified community mental health center or treatment center.
For facilities near you, please refer to the provider directory online, visit the member portal at MyMolina.com or call Member Services (833) 685-2102, TTY/TDD 711 for the hearing impaired.
If there is an emergency situation, you do not need a prior authorization. Please refer to Emergency services related to Behavioral Health.
Covered for members under the age of 21, referred through the EPDST program and screened through their PCP
Covered for Children under 21 years of age provided by Nevada Medicaid through Liberty dental.
For adults, 21 years of age and older, coverage is limited to emergency dental examinations and extractions, and in some instances false teeth (full and partial dentures to replace missing teeth). Contact Liberty Dental.
Coverage for items that are medically necessary as determined by the Nevada Medicaid and Nevada Check Up program includes:
- Certain medically needed equipment (e.g. wheelchairs, ventilators, etc.)
- Items that would not generally be useful to a person without an illness or an injury
Durable medical equipment is used to serve a medical purpose, fitted for use in the home, and able to withstand repeated use.
EPSDT is provided to members that are under 21 years old and does not require prior authorization. These services include:
- Screening services including a comprehensive health and developmental history (both physical and mental health)
- Comprehensive, unclothed physical exam
- Lead screening and testing
- Age-appropriate vaccinations
- Laboratory tests (including blood lead level assessment appropriate to age and risk)
- Health education
- Vision services
- Dental services referrals
- Hearing services
Other necessary health care, diagnostic services, treatment, and other measures described in Section 1905(a) of the Act to correct or ameliorate defects and physical and mental illnesses and conditions discovered by the screening services, whether or not such services are covered under the Medicaid State Plan.
Covered until the attending physician or the Provider treating the Member determines that the Member is sufficiently stabilized for transfer or discharge.
Public Crisis Teams and Providers of Crisis Intervention services render Emergency Services to Members experiencing a Behavioral Health crisis.
These services involve immediate and intensive interventions designed to help stabilize the Member and ensure stabilization, such as:
- Situational risk-of-harm assessments
- Follow-up and debriefing sessions to ensure stabilization and continuity of care
- Identification of referral sources for ongoing community Behavioral Health Services.
Coverage for members includes one eye exam, lenses and frames every 12 months.
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.
Covered for any member of childbearing age may receive Family Planning Services from any qualified Provider, including plan or non-plan providers. No referral needed. These services may include:
- Physical exams
- Birth control devices, implants, medication, and supplies
Other covered services for members 21 years of age or older include:
- Tubal ligations
These services that are not included for those members that are:
- Mentally incompetent
- Under the aged of 21 years old
Abortions are excluded from coverage, except when certain conditions exist. For example, to save the life of the mother, for rape or incest, or if medically necessary. Your provider will explain these services and ask you to sign
Coverage for members includes Hearing aid(s) and related supplies, as well as Hearing aid testing and repairs.
Replacement of lost or damaged ear mold(s) are covered only for those under 21.
Coverage is provided for Home Health Services that are medically necessary and receive Prior Authorization.
- Personal care services
- Home environment evaluation
- Dietitian services
- Skilled nursing services
- Home health aide services
- Respiratory therapy
- Physical therapy (limit restrictions apply)
- Occupational therapy (limit restrictions apply)
- Speech therapy (limit restrictions apply)
For complete list of limitations, please contact Member Services (833) 685-2102, TTY/TDD 711 for the hearing impaired.
Coverage is not provided for Home Health services in a hospital or office setting.
Coverage is provided for inpatient and outpatient hospital services that are medically necessary with a Prior Authorization.
Coverage is also provided when you get services in a hospital or are admitted to the hospital for Emergency or out-of-area Urgent Care Services. Prior authorization is not required for emergencies.
The following inpatient services are covered in a Participating Provider hospital or rehabilitation facility, when the services are generally and customarily provided by acute care general hospitals or rehabilitation facilities inside our service area:
- Room and board, including a private room if Medically Necessary
- Specialized care and critical care units
- General and special nursing care
- Operating and recover rooms
- Services of Participating Provider physicians, including consultation and treatment by Specialists
- Drugs prescribed in accord with the Universal Preferred Drug guidelines
- Radioactive materials used for therapeutic purposes
- Durable medical equipment and medical supplies
- Imaging, laboratory, and special procedures, including MRI, CT, and PET scans, and ultrasound imaging
- Mastectomies (removal of breast) and lymph node dissections
- Blood, blood products and their administration, blood storage (including the services and supplies of a blood bank)
- Physical, occupational, and speech therapy (including treatment in an organized, multidisciplinary rehabilitation program)
- Respiratory therapy
- Medical social services and discharge planning
Medically necessary lab tests are covered .
Coverage includes prenatal care, delivery services at a hospital or birthing center, pre-term labor, care for complications, and postpartum care.
Coverage provided in the Molina Healthcare of Nevada network and with a Prior Authorization for providers not in our network.
Coverage for all office visits to providers that are in the Molina Healthcare of Nevada network. Providers not in the Molina Healthcare of Nevada network require Prior Authorization.
For providers near you, please refer to the provider directory online, visit the member portal at MyMolina.com or call Member Services at (833) 685-2102, TTY/TDD 711 for hearing impaired
Coverage is provided with a Prior Authorization.
Coverage is provided for pharmacy prescriptions that are:
- Medically necessary
- Ordered by your provider who is in the Molina Healthcare of Nevada network. Check Find a Provider to see if you provider is in the network.
- On the Molina Healthcare Preferred Drug List (PDL). The PDL is the Molina Healthcare list of approved drugs that providers can order for you.
- Received through a pharmacy that is in the Molina Healthcare Pharmacy Network ( Medicaid | NV Check Up).
- Given while you are in a rest home, nursing home or convalescent hospital.
As an additional benefit, Molina Healthcare covers a 30-day supply of prescription drugs mailed to your home. Molina Healthcare also covers over-the-counter drugs on the PDL at no additional cost to you. You will need a prescription from a provider for the over-the-counter drug to be covered by Molina Healthcare.
Note: Certain drugs need prior approval by Molina Healthcare. Your provider needs to send Molina Healthcare a request and get prior authorization before these drugs will be covered.
Generic drugs have the same ingredients as brand name drugs. To be FDA (government approved) the generic drug must have the same active ingredient, strength and dosage as the brand name drug.
If your provider orders a brand name drug and there is a generic is available, Molina Healthcare will cover the generic drug. If your provider says you must have the brand name drug instead of the generic, he/she must submit a prior authorization request to Molina Healthcare’s Pharmacy Department.
Molina Healthcare wants to make sure you get medical care as soon as you think you are pregnant. If you think you are pregnant, see you PCP.
Once you are pregnant your PCP will want you to see an OB/GYN. You don’t need a referral or prior authorization to see an OB/GYN.
If you need help finding an OB/GYN, call Member Services at (833) 685-2102, TTY/TDD 711 for hearing impaired; we can help you arrange for your prenatal care.
Covered services include mammograms, well baby and well childcare, regular check-ups and screenings, as well as EPSDT services. These services do not require a prior authorization.
Covered for services ordered by a provider. Certain Radiology and X-Rays require Prior Authorization, such as CT scans, MRIs and MRAs.
Molina covers all RTC charges including admission, bed day rate, and ancillary services.
Covered for medically necessary services with a Prior Authorization for stays no longer than 180 calendar days. Items that are not medically necessary such as a private room are not covered.
Coverage for programs to help you stop smoking, call (866) 472-9483 TTY/TDD 711 for hearing impaired.
Some over-the-counter products for smoking cessation are covered with a prescription from a doctor.
Coverage for Speech, Occupational and Physical therapy services with a Prior Authorization.
Covered, with limitations, when Medically Necessary including Corneal, Kidney, Liver and Bone Marrow transplants.
For children up to age 21, any Medically Necessary transplant that is not experimental will be covered.
Non-emergent medical transportation is available through MTM. They arrange rides to covered services for members who have no other way to receive a ride to their routine medical appointments.
If you qualify for this service and need to arrange non-emergency transportation contact MTM at (844) 879-7341 or for hearing impaired contact (TTY/TDD: 711) or call Member Services at (833) 685-2102 (TTY/TDD: 711).
Non-emergent transportation is not available to Nevada Check Up members.
Call to schedule your ride. You must give at least 5 working days notice when scheduling transportation.
Covered for a sudden illness, injury, or condition that is not an emergency but needs to be treated right away or when your doctor is unavailable. Examples may include sprains, vomiting, rashes, and ear infections. Prior Authorization is not required.
Coverage of age-appropriate vaccination in accordance with the most current Advisory Committee on Immunization Practices (ACIP) schedule. No prior authorization is required.
Rewards and Enhanced Services
Members may receive transportation to certain SDOH resources, food banks, WIC, domestic violence agencies, housing authority and job interview or training and may have their children/family attend provider visits.
*Members need to request and receive approval for these requests through Member Services.
Molina will offer members 21 + $150 for acupuncture and massage therapy.
$100 gift card for members who attend a baby shower. To register, follow the instructions on the baby shower registration form.
One free Sam's Club Membership per family
Members who sign up and complete the three-month Asthma Disease Management Breathe with Ease® Program receive an allergy-free pillowcase and mattress cover.
For children under 18 who have been prescribed an inhaler, Molina will provide a second inhaler at no additional cost.
Free Boys and Girls Club membership for the after-school program for ages 6-18.
Free annual physical. Schedule an appointment with your provider. For ages 6-18.
For all mothers who wish to obtain electronic breast pumps.
$50 gift card after passing the tests and receiving certificate. Vouchers to take GED tests for free at authorized testing centers.
Varies based on household.
We cover certain genetic tests that are needed to determine the most effective course of care for oncology treatment.
The program provides a healthy food box. For members with diabetes, post-discharge from the hospital with a food prescription.
- Gift card for $25 for members who attend one postpartum visit 7-84 days after the birth of the baby.
- FREE car or booster seat after completing a prenatal visit during the first trimester or within 42 days of enrollment.
- Gift card for $50 ($100 max annually) gift card, yearly diabetic retinal eye exam and complete HbA1c lab work.
- Gift card for $25 after completing an annual mammogram screening; limited to one per member per year.
- Complete up to six well-child visits on time within a 15-month period and receive a $10 per visit (max $60 gift card) for 0-15 months old.
- Gift card for $25 (max) after completing two or more well-child visits when the child is 15-30 months.
- Gift card for $25/visit (max $25 gift card per year) after completing a well-child visit annually, 3-20 years old.
- Gift card for $25 after an office visit for cervical cancer screening (pap test).
- Gift card for $25 after an annual chlamydia screening. Requires member attestation, provider attestation or claim.
- Gift card for $25 after completing an annual syphilis screening and treated prior to giving birth. Requires member attestation, provider attestation or claim.
- Gift card for $50 after a follow-up visit with a behavioral health provider within seven days of discharge from an inpatient hospitalization for mental illness.
- Gift card for $25 after an annual adult preventive screening visit (limited to one per year).
This resource is powered by the Aunt Bertha community services directory and referral system: provides members on demand, 24/7 access to thousands of community resources access the state in areas of health, financial support, education, emergency resources, legal support, housing support, employment opportunities, transportation and food security. Visit MolinaHelpfinder.com
Members will receive up to 13 weeks of digital Weight Watchers (WW) services. Kurbo by WW (for chlilden 8-18 years old).
Medicaid members receive $30 per member household, per quarter for commonly used OTC items not covered through Nevada Medicaid. For more information, visit: NationsOTC.com/MolinaNV. To see a complete list of your covered 2023 products, Click Here.
Replace ID cards and Birth Certificates
Molina provides 8 hours of respite care per year for a member’s caregiver.
Receive one FREE physical for school or sports per year.
Pregnant women and new moms
From now until after you give birth, get the education and services you need to keep you and your baby healthy. Depending on your needs, you may receive:
- Counseling over the phone
- Educational workbooks and other resources
- Coordination with social services
- Case management services by a nurse
If you are pregnant:
- See your provider as soon as you find out you're having a baby
- Go to every provider visit for prenatal care - don't miss any appointments. These visits can tell you how your baby is growing and get you ready for birth. We want you to have a healthy pregnancy and baby!
- Annual sports physicals from a PCP for children ages 10-18
- Boys and Girls Club membership for children ages 6-18
As part of the program, you will also learn ways to stay healthy after your pregnancy.
We’re here to help your kids grow into healthy young adults. To help them succeed, Molina members get these extra benefits:
TEXT4BABY helps prepare members for motherhood by sending appointment reminders, personalized information on prenatal care, baby’s development, signs of labor, breastfeeding, and nutrition directly to members’ phones at no cost.
Members who are pregnant and register for the Pacify app receive a Pacify gift box and access to lactation consultants and other pregnancy resources and support. Visit Pacify.com/Molina for more information.
Members may request home-delivered meals to support nutritional needs during pregnancy and postpartum.
TruConnect free service plan includes a cell phone with free talk and text and free international calling to Mexico, Canada, China, Vietnam and South Korea. Free calling to TruConnect and Molina for support. Visit TruConnect.com/Molina for more information.
Additional $100 above the standard benefit for medically necessary and appropriate services (such as corrective lenses or contacts) every 24 months. For more information, visit: VSP.com/medicaid
A Prior Authorization is different than a referral. It means that Molina Healthcare of Nevada (not your network PCP or behavioral health provider) must give you approval before we will cover a specific service or an out-of-network provider. If you don’t get prior authorization, Molina Healthcare of Nevada may not cover the service.