Benefits and Services

Welcome Molina Complete Care (MCC) members!

With your MCC Medicaid benefits, you’ll get standard benefits like:

  • If you live with a behavioral health challenge, we offer the following support to help you meet your recovery goals:

    • Inpatient and outpatient treatment options
    • Mental Health Services (MHS), including:
      • Mental health case management
      • Therapeutic day treatment
      • Day treatment/partial hospitalization for adults
      • Intensive community treatment
      • Mental health skill-building services
      • Intensive In-Home
      • Psychosocial rehabilitation services
      • Behavioral therapy
      • Crisis Intervention and Stabilization
      • Peer support services
      • Residential treatment services

    Some behavioral health services are covered through Magellan of Virginia, the Department of Medical Assistance Services (DMAS) Behavioral Health Services Administrator. If you need behavioral health services, call us and we’ll help you find a provider that can help.

    You can find more information on behavioral health services in your member handbook.

    Behavioral health updates starting December 1st

    On December 1, 2021, Virginia Medicaid will be adding new behavioral health services to Medicaid members. 

    New clinically-proven behavioral health services starting December 1, 2021 

    1. Multisystemic Therapy (MST)—treatment program for members ages 12-17 with disruptive behavior, mood disorder and/or substance use. MST is delivered in home and community settings and includes family and caregivers. 
    Members must have a referral for treatment of behavioral or emotional problems from the juvenile justice, behavioral health, school or child welfare systems.

    2. Functional Family Therapy (FFT)—short-term treatment program for members ages 11-18 with serious emotional disturbance and substance use disorders. FFT is delivered in the member’s home. FFT also addresses parenting or caregiving challenges that affect the family unit.
    Members must have a referral for treatment of behavioral or emotional problems by the juvenile justice, behavioral health, school or child welfare systems. 

    For most members any transitions to new services should be seamless and you won’t have to do anything. Please call Member Services if you have any questions about services available after December 1, 2021. We’re here Monday through Friday from 8 a.m. to 8 p.m. local time.

    Commonwealth Coordinated Care Plus: 1-800-424-4524 (TTY 711)
    Medallion 4.0: 1-800-424-4518 (TTY 711)

     

 

Pharmacy Benefits

List of covered drugs

MCC has a list of covered drugs that we select with the help of doctors and pharmacists. This is called a preferred drug list. This list of covered drugs also includes all the drugs on the DMAS Preferred Drug List (PDL). The list tells you which drugs are covered by us and if there are any rules or restrictions on any drugs, such as a limit on the amount you can get.

To get medicines on the list of covered drugs, you first need to get a prescription from your doctor. Take the prescription to a pharmacy in the MCC network or have your doctor call it in.

MCC pays for enhanced over-the-counter (OTC) products for all members with an active prescription from a participating provider. These products can include, but are not limited to:

  • Glucosamine with or without chondroitin
  • Fish oil
  • Saliva substitute
  • Skin or wound products
  • Psyllium
  • Fleet prep kits
  • Various vitamins or combinations not covered by the Commonwealth’s Pharmacy Manual and Covered Services
 

Please review this list to find out if your drugs are covered. If you would like a paper copy of the list of covered drugs, please call Member Services and we will mail you a copy. The list may change during the year.

If you are on a drug that is impacted by a change to the list of covered drugs, you will be notified in writing 30 days prior to the change taking effect.

If you have any questions about your medicine(s) or about your MCC pharmacy benefits, please call our Member Services team.

List of covered drugs

Getting your medicines

For new medicines – When you get a prescription from your doctor, ask them to send it to a network pharmacy near you. You can find a list of pharmacies that work with MCC in our online provider directory. You may also take the prescription to the pharmacy that works with MCC and drop it off yourself.

For medicines you already take – If you already have medicines at a pharmacy that’s not on our list, you will need to pick a new in-network pharmacy. Once you do, simply ask the new pharmacy to get your prescription from your old pharmacy. Make sure you bring your Member ID card so you can show it to the pharmacist.

Specialty pharmacy program

MCC wants to help you get the care you need. Maybe you need to take a specialty medicine. Specialty medicines can be oral, but many times they are injected, infused, or inhaled medicines. These may need special storage or handling. MCC limits the amount of specialty drug fills to up to a 34-day supply.
Magellan Rx Specialty is our preferred specialty pharmacy. We’d like you to get your specialty medicine sent through the mail from Magellan Rx Specialty. Magellan Rx Specialty will work closely with you and your provider to give you what you need to help manage your condition.

Services and programs to support your needs
Magellan Rx Specialty pharmacy makes it easy for you to get your specialty medicine with services to help you including:

  • Coaching programs to help manage your condition
  • Free delivery to your home or another address within two days of ordering
  • Supplies such as syringes and needles at no cost
  • Highly trained pharmacists and nurses available to answer any questions
  • Insurance specialists to help you get the most out of your benefits
  • Online member portal where you can request refills and learn more
 

Get started today
If you have a new prescription or if you are requesting a refill from another pharmacy, please call Magellan Rx Specialty to get your medicine delivered to you at no cost. If you do not want to use Magellan Rx Specialty pharmacy, tell the pharmacy team member at the time of the call. They will make a change that will allow you to continue to get your specialty medicine at your current pharmacy.

Contact us
Have questions? Please call 1-866-554-2673 (TTY/TDD 1-800-424-0328). Our hours are Monday through Friday from 8 a.m. to 10 p.m. local time. The pharmacy is available 24 hours a day, seven days a week for emergencies.

Drug recalls

List of recalled drugs

Medicare and Medicaid services

If you have Medicare and Medicaid, some of your services will be covered by your Medicare plan and some will be covered by MCC. We are your CCC Plus Medicaid plan.

Types of services under Medicare

  • Inpatient hospital care (medical and psychiatric)
  • Outpatient care (medical and psychiatric)
  • Physician and specialist services
  • X-ray, lab work and diagnostic tests
  • Skilled nursing facility care
  • Home health care
  • Hospice care
  • Prescription drugs
  • Durable medical equipment

 

Types of services under CCC Plus Medicaid

  • Medicare copayments
  • Hospital and skilled nursing when Medicare benefits are exhausted
  • Long-term nursing facility care (custodial)
  • Home and community-based waiver services, like personal care and respite care, environmental/home modifications and assistive technology services
  • Community behavioral health services
  • Medicare non-covered services, like some over the counter medicines, medical equipment and supplies, and incontinence products

 

For more information about these services, contact your Medicare plan, visit Medicare.gov, or call Medicare at 1-800-633-4227 (TTY 1-877-486-2048).

For detailed information about your benefits, please review your member handbook.

Safelink wireless phone

Some MCC members are also eligible to receive SafeLink Wireless smartphones.

There are three easy ways to enroll in the SafeLink Wireless program:

  1. Visit www.safelink.com to apply online.
  2. Print and fill out the application below mail it in.
    Safelink Wireless member application (English)
    Safelink Wireless member application (Spanish)
  3. Call SafeLink at 1-877-631-2550.

Transportation

Do you need a ride to your healthcare appointments? Call Veyo at the number below to schedule a ride. Visit our “How do I?” page to read more about how to set up a ride to your appointments.

Veyo


Read these FAQs to learn more about Veyo transportation services: