Member Rights and Responsibilities

Molina Healthcare members have certain rights to help protect them. Providers and health care facilities should recognize member’s rights while they are receiving medical care, and members should also respect their health care providers.

Member Rights

We must provide information in a way that works for our members (in languages other than English, in Braille, in large print, or other alternate formats, etc.).

  • We must treat our members with fairness and respect at all times.
  • We must ensure that members get timely access to their covered services and drugs.
  • We must protect the privacy of our members’ personal health information.
  • We must give our members information about the plan, its network of providers, and their covered services.
  • We must support our members’ right to make decisions about their care.
  • Understand their health problems and participate in developing mutually agreed-upon treatment goals, to the degree possible.
  • Members have the right to make complaints and to ask us to reconsider decisions we have made.
  • Members can contact Molina Healthcare Member Services or their local Office for Civil Rights if they feel they are being treated unfairly or their rights are not being respected.
  • Members may request more information about their rights.


Member Responsibilities

  • Get familiar with their covered services and the rules they must follow to get these covered services.
  • If members have any other health insurance coverage or prescription drug coverage in addition to our plan, they are required to tell us.
  • Tell their doctor and other health care providers that they are enrolled in our plan.
  • Help their doctors and other providers help them by giving information, asking questions, and following through on their care.
  • Be considerate.
  • Pay what they owe.
  • Tell us if they move.
  • Call Member Services for help if they have questions or concerns.

Additional Member Responsibilities while using Non-Emergency Medical Transportation (NEMT) Services:

  • When requesting NEMT Services, you must provide the information requested by the person arranging or verifying your transportation.
  • You must follow all rules and regulations affecting your NEMT services.
  • You must return unused advanced funds. You must provide proof that you kept your medical appointment prior to receiving future advanced funds.
  • You must not verbally, sexually, or physically abuse or harass anyone while requesting or receiving NEMT services.
  • You must not lose bus tickets or tokens and must return any bus tickets or tokens that you do not use. You must use the bus tickets or tokens only to go to your medical appointment.
  • You must only use NEMT Services to travel to and from your medical appointments.
  • If you have arranged for an NEMT Service but something changes, and you no longer need the service, you must contact the person who helped you arrange your transportation as soon as possible.

For more detail on the member rights and responsibilities, please review your Provider Manual.

*Printed copies of information posted on our website are available upon request.