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Members

Frequently Asked Questions

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Q: How do I change my Primary Care Provider (PCP)?
A. There are two ways you can change your PCP.

  1. Go to My Molina and follow the instructions. If you have not registered for My Molina yet, you can do it online today.
  2. You can also call Member Services.

Q: How do I order a new ID card?
A. You can visit My Molina or call Molina Member Services.

Q: What drugs are covered? Are my drugs covered?
A. To find out what drugs are covered under your plan, view the Molina Dual Options Drug Formulary.

Q: How do I find out if a health care service or benefit is covered?
A. Go to "What's Covered" to find out about your benefits and services. You can visit My Molina or call Member Services.

Q. How can I get plan materials translated in my preferred language?
A. If you need your health plan information in a different language or format, call Member Services.

Q: What kind of transportation do I get? I need help with transportation.
A.
Go to "Services" to find out what transportation services are covered. You can also visit MyMolina.com or call Member Services.

Q. What if I have a complaint or concern?
A.
You can call Member Services with any questions or concerns. We have a dedicated team of Member Service Specialists to help resolve any issues or concerns. You can also click here to learn more about the Appeals and Grievances process.

Q. What if I believe I qualify for "Extra Help" for prescriptions?
A.
If you believe you have qualified for extra help and you believe you are paying an incorrect cost-sharing amount when you get your prescriptions at a pharmacy, our plan has established a process that allows you to either request assistance in obtaining evidence of your proper co-payment level, or, if you already have the evidence, to provide this evidence to us. The Best Available Evidence (BAE) is used to determine a member's Low Income Subsidy. Our Member Services department and Pharmacy department identify cases where the BAE policy applies. Members may send BAE documentation to establish eligibility or they may call Member Services to request assistance. Acceptable forms of evidence are:

  • Social Security Award Letter
  • Notice of Award
  • Supplemental Security Income

 

When we receive the evidence showing your copayment level, we will update our system so that you can pay the correct copayment when you get your next prescription at the pharmacy. If you overpay your copayment, we will reimburse you. Either we will forward a check to you in the amount of your overpayment or we will offset future copayments. If the pharmacy hasn't collected a copayment from you and is carrying your copayment as a debt owed by you, we may make the payment directly to the pharmacy. If the state paid on your behalf, we may make payment directly to the state.



Please contact Member Services if you have any questions.​

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