Members

Member Services Guide

memguide
Your Member Services Guide

Please read your Member Services Guide Handbook and keep it in a safe place where you can find it quickly. It is also called your "Combined Evidence of Coverage and Disclosure Form" or your "EOC". It tells you:

  • About your health plan.
  • About your benefits and what is covered.
  • How to get the services you need, including special health care needs.
  • How to contact us.
  • Your rights and responsibilities.

 
Read it today

2026 Medi-Cal Member Services Guide 

2026 Medi-Cal Member Services Guide - English

2026 Medi-Cal Member Services Guide - Spanish

2026 Medi-Cal Member Services Guide - Arabic 

2026 Medi-Cal Member Services Guide - Chinese Simplified 

2026 Medi-Cal Member Services Guide - Chinese Traditional

2026 Medi-Cal Member Services Guide - Farsi

2026 Medi-Cal Member Services Guide - Hmong

2026 Medi-Cal Member Services Guide - Russian

2026 Medi-Cal Member Services Guide - Tagalog 

2026 Medi-Cal Member Services Guide - Vietnamese 

2026 Los Angeles Medi-Cal Member Services Guide

2026 Los Angeles Medi-Cal Member Services Guide - English

2026 Los Angeles Medi-Cal Member Services Guide - Spanish

2026 Los Angeles Medi-Cal Member Services Guide - Arabic

2026 Los Angeles Medi-Cal Member Services Guide - Armenian

2026 Los Angeles Medi-Cal Member Services Guide - Chinese Simplified 

2026 Los Angeles Medi-Cal Member Services Guide - Chinese Traditional

2026 Los Angeles Medi-Cal Member Services Guide - Farsi

2026 Los Angeles Medi-Cal Member Services Guide - Khmer

2026 Los Angeles Medi-Cal Member Services Guide - Korean

2026 Los Angeles Medi-Cal Member Services Guide - Russian

2026 Los Angeles Medi-Cal Member Services Guide - Tagalog

2026 Los Angeles Medi-Cal Member Services Guide - Vietnamese

 

2026 Medi-Cal Member Services Guide Errata

2026 Los Angeles Medi-Cal Member Services Guide Errata - English 

2026 Medi-Cal Members Services Guide Errata - English

 

Non-Discrimination Form

Non- Discrimination Form

Need your Member Services Guide in a different language or format? 

Call Member Services at (888) 665-4621.

 

CMS-0057 Prior Authorization Annual Reporting

This report shows how prior authorization requests are handled, such as how many were approved or denied and how quickly decisions were made. To find out if a specific service needs prior authorization, members and providers should check the plan’s Prior Authorization Guide or use the Prior Authorization Lookup Tool.

icon Prior Authorization Guide 2025
icon Prior Authorization Lookup Tool

California Medicaid Prior Authorization Annual Report 2025


Prior Authorization Statistics
Molina Healthcare Inc
Percentage
The percentage of STANDARD prior authorization requests that were approved, aggregated for all items and services. 98%
The percentage of STANDARD prior authorization requests that were denied, aggregated for all items and services. 2%
The percentage of STANDARD prior authorization requests that were approved after an appeal, aggregated for all items and services. 43%
The percentage of EXPEDITED prior authorization requests that were approved after an appeal, aggregated for all items and services. 41%
The percentage of STANDARD prior authorization requests for which the review timeframe was extended, and the request was approved, aggregated for all items and services. 72%
The percentage of EXPEDITED prior authorization requests for which the review timeframe was extended, and the request was approved, aggregated for all items and services. 74%
The percentage of EXPEDITED prior authorization requests that were approved, aggregated for all items and services. 98%
The percentage of EXPEDITED prior authorization requests that were denied, aggregated for all items and services. 2%
Timing
Average time that elapsed between the submission of a request and a determination by the payor, plan or issuer, for STANDARD prior authorizations, aggregated for all items and services. (Measured in days) 2
Median time that elapsed between the submission of a request and a determination by the payor, plan, issuer, for STANDARD prior authorizations, aggregated for all items and services. (Measured in days) 1
Average time that elapsed between the submission of a request and a decision by the payor, plan or issuer, for EXPEDITED prior authorizations, aggregated for all items and services. (Measured in hours) 16
Median time that elapsed between the submission of a request and a decision by the payor, plan, issuer, for EXPEDITED prior authorizations, aggregated for all items and services. (Measured in hours) 3