Member Rights & Responsibilities
Below are the Molina Healthcare rights and responsibilities as written in the Molina Healthcare Member Handbook. State law requires that health care providers or health care facilities recognize Member rights while they are receiving medical care and that Members respect the health care providers.
Members have the right to:
- Be treated with courtesy and respect, with appreciation of his or her individual dignity, and with protection of his or her need for privacy.
- A prompt and reasonable response to questions and requests.
- Know who is providing medical services and who is responsible for his or her care.
- Know what patient support services are available, including whether an interpreter is available if he or she does not speak English.
- Know what rules and regulations apply to his or her conduct.
- Be given by health care provider information concerning diagnosis, planned course of treatment, alternatives, risks, and prognosis.
- Be able to take part in decisions about his or her health care.
- Have an open discussion about his or her appropriate clinically or medically necessary treatment options for their conditions, regardless of cost or benefit coverage.
- Refuse any treatment, except as otherwise provided by law.
- Be given, upon request, full information and necessary counseling on the availability of known financial resources for his or her care.
- If eligible for Medicare, to know, upon request and in advance of treatment, whether the health care provider or health care facility accepts the Medicare assignment rate.
- Receive, upon request, prior to treatment, a reasonable estimate of charges for medical care.
- Receive a copy of reasonably clear and understandable, itemized bill and, upon request, to have the charges explained.
- Impartial access to medical treatment or accommodations, regardless of race, national origin, religion, physical handicap, or source of payment.
- Treatment for any emergency medical condition that will deteriorate from failure to provide treatment.
- Know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such experimental research.
- Receive information about Molina Healthcare, its services, its practitioners and providers and members’ right and responsibilities.
- Make recommendations about Molina Healthcare’s member rights and responsibilities policies.
- Voice complaints or appeals about the organization or the care it provides.
- Express grievance regarding any violation of his or her rights, as stated in Florida law, through the grievance procedure of the health care provider or health care facility which served him or her and to the appropriate state licensing agency listed below.
Office of Civil Rights
United States Department of Health and Human Services
105 W. Adams, 16th Floor
Chicago, Illinois 60603
(312) 886-2359 (312) 353-5693 TTY
Bureau of Civil Rights
Florida Agency of Health Care Administration
2727 Mahan Drive
Tallahassee, FL 32308
Members have the responsibility for:
- Providing to the health care provider, to the best of his or her knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications and other matters relating to his or her health.
- Reporting unexpected changes in his or her condition to the health care provider.
- Reporting to the health care provider whether he or she comprehends a contemplated course of action and what is expected of him or her.
- Follow the care plan agreed- upon with his or her provider.
- Keeping appointments and, when he or she is unable to do so for any reason, to notify the health care provider or health care facility.
- His or her actions if he or she refuses treatment or does not follow the health care provider’s instructions.
- Assuring that the financial obligations of his or her health care are fulfilled as promptly as possible.
- Following health care facility rules and regulations affecting patient care and conduct.
- Understanding his or her health problems and participating in developing mutually agreed-upon treatment goals to the degree possible.