Members

Member Rights & Responsibilities

Virtual Care

Did you know that as a member of Molina Healthcare, you have certain rights and responsibilities? Knowing your rights and responsibilities will help you, your family, your provider, and Molina Healthcare ensure that you get the covered services and care that you need. 

You have the right to:

  • Be treated  with dignity, respect, and fairness, and to receive health care services free from discrimination based on age, color, disability, national origin, marital status, race, religion, or sex

  • Be given clear information about your illness, or medical condition; understand the treatment options, risks and benefits; and make an informed decision about whether you will receive treatment

  • Make choices about your health care, including saying “no” to treatment. Saying “no” won’t get you removed from your health plan

  • Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience, or retaliation

  • Request a a copy of the Member Handbook, Provider Directory, or any of our materials in print, another language or format — such as Braille, large print, or audio — at no cost and receive them within five business days

  • Receive information on the medical services provided by their health plan

  • Receive proper medical care 24 hours a day, 7 days a week

  • Choose your health plan and primary care provider (PCP), have access to your health plan and PCP, and change your PCP

  • Talk with your doctor and health plan, and know your medical information will be kept confidential

  • Make advance directives, if desired, and receive assistance if needed

  • Have interpreters at no cost, if necessary, during medical appointments and in all discussions with your PCP or Molina Healthcare

  • Request an appeal if services are denied, terminated, or reduced

  • Make a complaint about a provider or Molina Healthcare, and receive a timely response

  • Change their health plan within 90 days of initial enrollment or every 12 months without cause thereafter

  • Use your rights without it affecting the way you are treated by Molina, its providers, or Nebraska Medicaid

 

You have the responsibility to:

  • Understand, to the best of your ability, how Molina Healthcare is used to receive health care

  • Take your Medicaid ID card and health plan ID card to all medical, dental and pharmacy visits

  • Keep your scheduled appointments and call your provider’s office at least 24 hours in advance if your appointment must be rescheduled

  • Tell your doctor about any medical problems and ask questions about things you do not understand

  • Follow the care plan that you have agreed on with your provider

  • Assist with the transfer of your medical records

  • Receive services from your PCP or primary care dentist unless they refer you to another provider

  • Cooperate with all Heritage Health inquiries and surveys

 

*You may request printed copies of all content posted on our website.