Member Rights and Responsibilities
What are my Rights?
You have the right to:
- Be treated with respect and dignity by everyone who works with Molina Healthcare.
- Get information about Molina Healthcare, our providers, our doctors, our services and your rights and
- Choose your “main” doctor from Molina Healthcare’s network. This doctor is called a primary care doctor or
- Be informed about your health. If you have an illness, you have the right to be told about treatment options regardless
of cost or benefit coverage. You have the right to have all your health questions answered.
- Help make decisions about your health care. You have the right to refuse medical treatment.
Privacy. Molina Healthcare keeps your medical records private.*
- See your medical record, including the results of Initial Health Assessment (IHA). You also have the right
to get a copy of and/or correct your medical record where legally okay.*
- Complain about Molina Healthcare or your care. You can call, fax, email or write to Molina Healthcare’s Member
- Appeal Molina Healthcare’s decisions. You have the right to have someone speak for you during a grievance.
Ask for a State Fair Hearing by calling toll-free (801) 538-6576. You also have the right to get information
on how to get an expedited State Fair Hearing.
- Disenroll from Molina Healthcare (leave the Molina Healthcare Health Plan).
- Ask for a second opinion about your health condition.
- Ask for someone outside Molina Healthcare to look into therapies that are experimental or being done as part
- Decide in advance how you want to be cared for in case you have a life-threatening illness or injury.
- Get interpreter services on a 24-hour basis, at no cost, to help talk with your doctor or us if you speak a
language other than English.
- Not be asked to bring minor, friend, or family member with you to act as an interpreter.
- Get information about Molina Healthcare, our providers, or your health in the language you prefer.
- Ask for and get materials in other formats such as larger size print, audio, and Braille upon request and
in a timely fashion appropriate for the format being requested and in accordance with state laws.
- Receive instructions on how you can view online or request a copy of Molina Healthcare’s non-proprietary
clinical and administrative policies and procedures.
- Get a copy of Molina Healthcare’s list of approved drugs (drug formulary) on request.
- Submit a grievance if you did not get medically needed medications after an emergency visit at one of Molina
Healthcare’s contracted hospitals.
- Access family planning services, Federally Qualified Health Centers, Indian Health Facilities, sexually
transmitted disease services, and Emergency services, outside of Molina Healthcare’s network according to
federal laws. You do not need to get Molina Healthcare’s approval first.
- Get minor consent services.
- Not to be treated poorly by Molina Healthcare, their doctors or the Department of Health for acting on any of
- Make recommendations regarding the organization’s member rights and responsibilities policies.
- Be free from controls or isolation used to pressure, punish or seek revenge.
- File a grievance or complaint if you believe your language needs were not met by the plan.
*Subject to State and Federal laws.
What are my Responsibilities?
- Learn and ask about your health benefits. If you have questions about your benefits call toll-free (888) 483-
- Give information to your doctor, provider, or Molina Healthcare that is needed to care for you.
- Be active in decisions about your health care.
- Follow the care plans and instructions for care that you have agreed on with your doctor(s).
- Build and keep a strong patient-doctor relationship.
- Cooperate with your doctor and their staff, keep appointments, and be on time. If you are going to be late
or cannot keep your appointment, you should call the doctor’s office.
- Give your State Medicaid card when getting medical care. You have the responsibility to not give your card
to others and let Molina Healthcare or the State know about any fraud or wrongdoing.
- Understand your health problems and participate in developing mutually agreed-upon treatment goals as
you are able.
These Member Rights and Responsibilities are also listed in your Member Handbook.
If you have any problem reading or understanding this or any Molina Healthcare information, call Member Services at (888) 483-0760. We can explain in English or in your primary language. You may request printed versions of these materials and they will be sent to you free of charge and within five business days. We may have it printed in other languages. You may ask for it in braille, large print, or audio. If you are hearing impaired, dial 711 for the Utah Relay Service