Molinalogo

In addition to the complaint processes offered by Molina Healthcare, members have the right to as for a Fair Hearing from the State of Texas at any time during the process. They have a right to ask for a Fair Hearing even if an appeal hasn’t been filed with Molina Healthcare.  They have the right to ask for a health care service the member or the member’s doctor requested has been denied, delayed or modified. Members may ask for a State Fair Hearing by contacting us toll-free at (866) 449-6849 TTY (English) (800) 735-2989, (Spanish) (800) 662-4954 to tell us about your problem. A Molina Member Services Representative can help you file a fair hearing. Just call 866-449-6849.  Please call within ninety (90) days after the order or action complained.

 

If a member is currently receiving a medical service that is going to be reduced or stopped, they may continue to get the same medical service until the hearing.  This can happen if the hearing is requested within ten (10) days from the date the denial letter was postmarked or personally delivered to the member.  This can also happen if the hearing is requested before the date of medical service is needed.

 

Members may write or call toll-free at any time during the appeals process. Members can bring someone who knows about the case to attend the hearing with the member, if they want. Members may also have someone else to represent them.  This person can be a doctor, a friend or a relative.