Affinity de Molina Healthcare utiliza una lista de medicamentos preferidos (PDL), que es la lista de medicamentos recetados cubiertos. Es revisada y aprobada por doctores y farmacéuticos. Debe obtener...
Senior Whole Health has various programs and services to offer you. There are many ways you can be referred to a program or service. One way to enroll is through your provider. You also can self-refer...
Living with health problems and managing them can be hard. We offer care management services and programs for members who need extra help with a health problem. This can be any adult or child who is g...
¿Qué es una denegación? Una denegación significa que Molina Healthcare le indica a un proveedor y a usted que los servicios no se prestarán o que las facturas no serán pagadas. Si le denegamos un serv...
A grievance is an oral or written expression of dissatisfaction, including any complaint, dispute, request for reconsideration, or appeal made by a member.What types of problems might lead to you fili...
Los miembros pueden solicitar una revisión médica independiente (IMR, por sus iniciales en inglés) de un servicio de atención médica en disputa al Departamento de Atención de Salud Administrada (DMHC,...
You can find answers to your questions below! Also, check out our glossary to look up any words that may be confusing. Don’t see your question? Just give us a call!
Transparency in Coverage
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You can qualify for special enrollment prior to January 2015 if you’ve had a change in life event. This is known as the Special Enrollment Period. Life events include:Losing your job or having a chang...
Molina Healthcare staff will help you coordinate your careLiving with health problems and managing them can be hard. We offer special services and programs for adult and child members who need extra h...
A complaint is an oral or written expression of not being satisfied. This can be any complaint. This can be a dispute. This can be a request for reconsideration. This can be a appeal made by a mem...
