Non-Discrimination Notification

Molina Healthcare of Wisconsin Medicaid

 

 

Molina Healthcare of Wisconsin (Molina) complies with all Federal civil rights laws that relate to healthcare services. Molina offers healthcare services to all members without regard to race, color, national origin, age, disability, or sex. Molina does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. This includes gender identity, pregnancy and sex stereotyping.

 

To help you talk with us, Molina provides services free of charge:

 

 

•   Aids and services to people with disabilities

•   Skilled sign language interpreters

•   Written material in other formats (large print, audio, accessible electronic formats, Braille)

•   Language services to people who speak another language or have limited English skills

•   Skilled interpreters

•   Written material translated in your language

•   Material that is simply written in plain language

If you need these services, contact Molina Member Services at (888) 999-2404, TTY: (800) 947-3529 or 711.

 

If you think that Molina failed to provide these services or treated you differently based on your race, color, national origin, age, disability, or sex, you can file a complaint. You can file a complaint in person, by mail, fax, or email. If you need help writing your complaint, we will help you. Call our Civil Rights Coordinator at

(866) 606-3889. Mail your complaint to:

 

 

Civil Rights Coordinator

200 Oceangate

Long Beach, CA 90802

 

 

You can also email your complaint to civil.rights@molinahealthcare.com. Or, fax your complaint to

(414) 831-2886.

 

 

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for

Civil Rights. Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html. You can mail it to:

 

 

U.S. Department of Health and Human Services

200 Independence Avenue, SW Room 509F, HHH

Building Washington, D.C. 20201

 

 

You can also send it to a website through the Office for Civil Rights Complaint Portal, available at https://

ocrportal.hhs.gov/ocr/portal/lobby.jsf.

 

 

If you need help, call 1-800-368-1019; TTY 800-537-7697.

 

 

 

 

MOLINA HEALTHCARE NOTICE 1557 - WI MEDICAID UPDATED 06.2022

5245865WI0918


 

Non-Discrimination Notification Tag Line - Section 1557

Molina Healthcare of Wisconsin Medicaid

English              ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-888-999-2404 (TTY: 711).

 

Spanish              ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia linística. Llame al 1-888-999-2404 (TTY: 711).

 

Hmong               LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau 1-888-999-2404 (TTY: 711).

 

Chinese

 

 

Laotian             

Burmese            

Russian              

Somali               Somali FIIRO GAAR AH: Hadii aad ku hadasho Ingiriisiga, adeega kaalmada luuqada, oo bilaa lacag ah, ayaa kuu diyaar ah. Lahadal 1-888-999-2404 (TTY: 711).

 

German              ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleis- tungen zur Verfügung. Rufnummer: 1-888-999-2404 (TTY: 711).

 

Arabic                        

Korean

 

 

Vietnamese        CHÚ Ý: Nếu bn nói Tiếng Việt, các dịch vụ h tr ngôn ngữ miễn p dành cho bn. Gi s 1-888-999-2404 (TTY: 711).


 

Pennsylvanian

Dutch


 

Wann du Deitsch (Pennsylvania German schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff:

Call 1-888-999-2404 (TTY: 711).


French                ATTENTION : Si vous parlez français, des services daide linguistique vous sont proposés gratuitement. Appelez le 1-888-999-2404 (TTY : 711).

 

Polish                 UWAGA: Jeżeli mówisz po polsku, możesz skorzyst z bezpłatnej pomocy zykowej. Za- dzwoń pod numer 1-888-999-2404 (TTY: 711).

 

Hindi

 

 

Albanian*           KUJDES: Nëse flitni shqip, për ju ka në dispozicion shërbime të asistencës gjuhësore, pa pag- esë. Telefononi në 1-888-999-2404 (TTY: 711).

 

Tagalog              PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tu- long sa wika nang walang bayad. Tumawag sa 1-888-999-2404 (TTY: 711).


 

Serbo- Croatian


 

PAŽNJA: Ako govorite srpsko-hrvatski imate pravo na besplatnu jezičnu pomoć. Nazovite

1-888-999-2404 (TTY: 711).                                                                                   21969FRMMDWIENL MHWI – 1557 tag lines