For Pharmacy forms, please go to our Forms page.
VA Medicaid 90-Day Drug List Update
The Department of Medical Assistance Services (DMAS) implemented a new permanent policy allowing ...
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2025 Documentos de Beneficios de Valor Agregado (VAB)
Información del Programa de Recompensas Saludables
Formulario de certificación pediátrica o para adultos de Healthy Re...
Prescription medications are covered when:
They are ordered by your provider or another doctor treating you or your child and the drug is listed on the Utah Medicaid Preferred Drug List and
U...
What’s covered
Prescription drugs
Prescription medications are covered when:
They are ordered by your provider or another doctor treating you or your child and the drug is listed on the Molina He...
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Please click on a form below to view a PDF printable version.
Claims
Provider Dispute Resolution Request Form
Credentialing
CAQH Provider Data Portal
HIV and AIDS Specialist Form
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Primary Care Provider (PCP)
A primary care provider (PCP) is your main doctor. It can also be a nurse or clinic. This doctor knows you well. Your main doctor will treat most of your healthcare needs. ...
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