Member Materials and Forms
Here you can find important documents about your Molina Healthcare (Molina) health plan. Click the links below for more information.
New Members
We want to help get you the most out of your health plan. To get started, review your new member Quick Start Guide we sent you in the mail:
Molina Quick Start Guide 2023 (English)
Molina Quick Start Guide 2023 (Spanish)
Member Handbooks
Your member handbook will help you understand your benefits and how you can best get help from Molina. It explains your healthcare, prescription drug, transportation, and benefits coverage with Molina. It tells you how best to make your health plan work for you.
Feel free to share this handbook with a family member or someone who knows your healthcare needs.
When you have a question, check this handbook, call Member Services, or call your Care Coordinator if you have one.
Molina Medicaid Member Handbook 2024 (English)
Molina Medicaid Member Handbook 2023 (English)Molina Medicaid Member Handbook 2023 (Spanish)
Printed copies of the Member Handbook are available free of charge upon request.
Transportation Brochure (NEMT and Value-Added Benefit)
Healthy Rewards Member Attestation Form
Provider and pharmacy directories
These provider directories list the doctors and pharmacies in your area that work with Molina. These are updated monthly.
October 2024
Iowa Medicaid Provider Directory (English)
Iowa Medicaid Provider Directory (Spanish)
Covered Medications
Molina Healthcare covers all medications listed on the Iowa Medicaid Preferred Drug List (PDL). These are drugs we prefer your Primary Care Provider to prescribe.
Machine Readable Preferred Drug List
Member forms
Click on the links below to access important member forms.
Appeals forms
Medicaid Member Appeals Form (English)
Medicaid Member Appeals Form (Spanish)
Medicaid Member Appeals Form with AOR
Consent to release PHI forms
Medicaid Member Consent to Release PHI Form (English)
Medicaid Member Consent to Release PHI Form (Spanish)
Help in other languages or alternate formats
This website and other plan materials are available for free in other languages and formats including in print, large print, Braille or audio CD. To request the information in an alternate format and/or language, call Member Services. This call is toll free.
Member Services: (844) 236-0894 (TTY 711)
Our bilingual staff and interpreters are trained professionals. They understand medical and treatment information. They can help you communicate with your health care professionals, your family members or your friends about treatment and medical history. And they can provide health education.
If you have any problems reading or understanding this information, please contact Member Services at for help at no cost to you.
Additionally, members with alternative hearing or speech communication needs can dial 711 to reach a Telecommunications Relay Services (TRS) operator who will help you reach Molina’s Member Services. Voice and TRS users can make a 711 call from any telephone anywhere in the United States free of charge.
If you do not speak English, call Member Services. We have access to interpreter services and can help answer your questions in your language. We can also help you find a health care provider who can communicate with you in your language.
Notice of privacy practices
This notice describes how medical information about you may be used and DISCLOSED and how you can get access to this information. PLEASE READ THIS NOTICE CAREFULLY. Or you can download and print the information:
Notice of Privacy Practices (English)
Notice of Privacy Practices (Spanish)
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