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Provider Bulletins
January 28, 2025 Unblocking Molina Healthcare fax numbers for UM communications   Dear Healthcare Provider,   We hope this message finds you well. We are reaching out to inform you about an important...
/providers/wi/medicaid/comm/2025ProvBull_1-27_UM.aspx
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Frequently Used Forms
Making Changes? Please notify Molina Healthcare at least 30 days in adva...
/providers/il/marketplace/forms/fuf.aspx
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Claims & Authorizations
jquery-2.1.3.min.js|jquery.validate.min.js|jquery.validate.unobtrusive.min.js|jquery.unobtrusive-ajax.min.js|form.validate.js|form.tracking.js|form.conditions.js|jquery-2.2.4.min.js 20200514T000000Z C...
/providers/ky/passportmedicare/claims.aspx
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Contact Us
Molina Dual Options Plan (MI Health Plan) 880 West Long Lake Suite 600 Troy, MI 48098 Provider Services (855) 322-4077 24-Hour Nurse Advice Line English, Spanish & Arabic: (844) 489-2541 TTY/TDD: 71...
/providers/mi/duals/contacts/contactus.aspx
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Pharmacy Prior Authorization Forms
   Prior Authorization Request Form  Prior Authorization Medications Form  Universal Synagis Prior Authorization Form    Adobe Acrobat Reader is required to view the file(s) above. Download a no-cost ...
/providers/sc/medicaid/drug/forms.aspx
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Frequently Used Forms
a:link {color: #009EA0;} #formList ul { list-style-type: none; } #formList ul, li { margin-left: -13px; position: relative; padding-left: 27px; } #formList ul ...
/providers/wa/medicaid/forms/fuf.aspx
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Drug Formulary
 2024 Medicare-Medicaid Plan/Dual Options Drug Formulary Additional Pharmacy Benefit Information  2024 Prior Authorization Grid  2024 Step Therapy Grid  2024 Medicare Part D Drug (J-Code) Step Therapy...
/providers/il/duals/drug/formulary.aspx
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Contact Us
    Molina Healthcare of Michigan 880 West Long Lake Road Troy, MI 48098 Business Hours: 8:00 a.m. - 5:00 p.m. Monday -...
/providers/mi/medicaid/contacts/contact_info.aspx
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Pharmacy Prior Authorization Forms | Passport Health Plan by Molina Healthcare
  Pharmacy Prior Authorization Contact Information Pharmacy Benefit Drugs (MedImpact): KY Medicaid Universal PA Request Form – Pharmacy Benefit Phone: (800) 210-7628 Prior Authorization Call Center: ...
/providers/ky/medicaid/drug/Pharmacy-Prior-Authorization-Forms.aspx
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Prior Authorization Request Procedure
For Managed Medicaid & HARP members: Starting April 1, 2023, prescriptions will not be covered by Molina Healthcare. They will be covered by Medicaid NYRx, the Medicaid pharmacy program. Medicaid ...
/providers/ny/medicaid/drug/authorization.aspx
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