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Members

Member Rights & Responsibilities

Doctor and patient talking

MHO complies with all applicable Federal and State laws that pertain to member rights and ensure its staff and affiliated providers take those rights into account when providing services to members.

MHO member rights and responsibilities statement outlines that members have the right to the following:

  • To receive all the services that Molina Healthcare must provide.
  • To be treated with respect and with regard for your dignity and privacy.
  • To be sure that your medical record information will be kept private.
  • To be given information about your health. This information may also be available to someone who you have legally approved to have the information or who you have said should be reached in an emergency when it is not in the best interest of your health to give it to you.
  • To be able to take part in decisions about your health care unless it is not in your best interest.
  • To get information on any medical care treatment, given in a way that you can follow.
  • To be sure that others cannot hear or see you when you are getting medical care.
  • To be free from any form of restraint or seclusion used as a means of force, discipline, ease, or revenge as specified in Federal regulations.
  • To ask, and get a copy of your medical records, and to be able to ask that the record be changed/corrected if needed.
  • To be able to say yes or no to having any information about you given out unless Molina Healthcare has to by law.
  • To be able to say no to treatment or therapy. If you say no, the provider or Molina Healthcare must talk to you about what could happen and they must put a note in your medical record about it.
  • To be able to file an appeal, a grievance (complaint) or state hearing.
  • To be able to get all Molina Healthcare written member information from Molina Healthcare:
    • At no cost to you;
    • In the prevalent non-English languages of members in Molina Healthcare’s service area;
    • In other ways, to help with the special needs of members who may have trouble reading the information for any reason.
  • To be able to get help free of charge from Molina Healthcare and its providers if you do not speak English or need help in understanding information.
  • To be able to get help with sign language if you are hearing impaired.
  • To be told if the health care provider is a student and to be able to refuse his/her care.
  • To be told of any experimental care and to be able to refuse to be part of the care.
  • To make advance directives (a living will).
  • To file any complaint about not following your advance directives with the Ohio Department of Health.
  • To change your Primary Care Provider (PCP) to another PCP on Molina Healthcare's panel at least monthly. Molina Healthcare must send you something in writing that says who the new PCP is and the date the change began.
  • To be free to carry out your rights and know that Molina Healthcare, its providers or ODM will not hold this against you.
  • To know that Molina Healthcare must follow all federal and state laws and other laws about privacy that apply.
  • To choose the provider that gives you care whenever possible and appropriate.
  • If you are a female, to be able to go to a women's health provider on Molina Healthcare's panel for covered women's health services.
  • To be able to get a second opinion from a qualified provider on Molina Healthcare's plan. If a qualified provider is not able to see you, Molina Healthcare must set up a visit with a provider not on our panel. These services are available at no cost to you.
  • To get information about Molina Healthcare from us.
  • To contact the United States Department of Health and Human Services Office of Civil Rights and/or the Ohio Department of Medicaid Bureau of Civil Rights with any complaint of discrimination based on race, color, religion, sex, sexual orientation, age, disability, national origin, veteran's status, ancestry, health status, or need for health services.
  • To receive information about Molina Healthcare, covered benefits and the providers contracted to provide services.
  • To openly discuss your treatment options, regardless of cost or benefit coverage, in a way that is easy to understand
  • To receive information about your member rights and responsibilities.
  • To make recommendations about Molina Healthcare's member rights and responsibilities policies.

MHO member rights and responsibilities statement outlines that members have the following responsibilities

Always carry your Molina Healthcare ID Card and do not let anyone else use your ID card.

  • Keep appointments and be on time.
  • If you require transportation, call Molina Healthcare at least 48 hours in advance whenever possible.
  • Call your provider 24 hours in advance if you are going to be late or if you cannot keep your appointment.
  • Share important information (to the extent possible) with Molina Healthcare and your providers so that they can give you appropriate care.
  • Understand your health conditions and be active in decisions about your health care.
  • Work with your provider to develop treatment goals and follow the care plan that you and your provider have developed.
  • Ask questions if you do not understand your benefits.
  • Call Molina Healthcare within 24 hours of a visit to the emergency department or an unexpected stay in the hospital.
  • Inform Molina Healthcare if you would like to change your PCP. Molina Healthcare will verify that the PCP you select is contracted with Molina Healthcare and is accepting new patients.
  • Inform Molina Healthcare and your county caseworker if you change your name, address or telephone number or if you have any changes that could affect your eligibility.
  • Let Molina Healthcare and your health care provider know if you or any of the members of your family have other health insurance coverage.
  • Report any fraud or wrongdoing to Molina Healthcare or the proper authorities.

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