YOUR RIGHTS AND RESPONSIBILITIES

What are my rights and responsibilities as a Molina Healthcare Member? These rights and responsibilities are posted on the Molina Healthcare web site: MolinaMarketplace.com.

YOUR RIGHTS

You have the right to:

  • Be treated with respect and recognition of Your dignity by everyone who works with Molina.
  • Get information about Molina, Our providers, Our doctors, Our services and Members’ rights and responsibilities.
  • Choose Your “main” doctor from Molina’s list of Participating Providers (This doctor is called Your Primary Care Doctor or Personal Doctor).
  • Be informed about Your health. If You have an illness, You have the right to be informed of all treatment options regardless of cost or benefit coverage. You have the right to have all Your questions about Your health answered.
  • Help make decisions about Your health care. You have the right to refuse medical treatment.
  • You have a right to Privacy. We keep Your medical records private.*
  • See Your medical record. You also have the right to get a copy of and correct Your medical record where legally allowed.*
  • Complain about Molina or Your care. You can call, fax, e-mail or write to Molina’s Customer Support Center.
  • Appeal Molina’s decisions. You have the right to have someone speak for You during Your grievance.
  • Disenroll from Molina (leave the Molina Policy).
  • Ask for a second opinion about Your health condition.
  • Ask for someone outside Molina to look into therapies that are Experimental or Investigational.
  • 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 You talk with Your doctor or with Us if You prefer to speak a language other than English.
  • Get information about Molina, Your 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.
  • Free Information on medical necessity criteria due to adverse benefit determinations.
  • Get a copy of Molina’s list of approved drugs (Drug Formulary) on request.
  • Submit a grievance if You do not get Medically Necessary medications after an Emergency visit at one of Molina’s contracted hospitals.
  • Not to be treated poorly by Molina or Your doctors for acting on any of these rights.
  • Make recommendations regarding Molina’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 linguistic needs were not met by Molina.

Know your rights under the Balance Billing Protection Act: Please click here.


*Subject to State and Federal laws

 

Your Responsibilities

You have the responsibility to:

Learn and ask questions about Your health benefits. If You have a question about Your benefits, call toll-free at 1 (888)858-3492.

  • 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 for You that You have agreed on with Your doctor(s).
  • Build and keep a strong patient-doctor relationship. Cooperate with Your doctor and staff. Keep appointments and be on time. If You are going to be late or cannot keep Your appointment, call Your doctor’s office.
  • Give Your Molina card when getting medical care. Do not give Your card to others. Let Molina know about any fraud or wrongdoing.
  • Understand Your health problems and participate in developing mutually agreed-upon treatment goals, as You are able.

 

Protected individuals, adult dependents, and qualified minors can request Molina treat their information as confidential. To do so individuals must submit a Non-Disclosure Directive to Molina by one of the following ways:
Downloading the Non-Disclosure Directive here