Molinalogo

What is a Medicare-Medicaid plan?

A. Molina Dual Options MI Health Link is a Medicare-Medicaid Plan. A Medicare-Medicaid Plan is an organization made up of doctors, hospitals, pharmacies, providers of long term supports and services, and other providers. It also has Care Coordinators and care teams to help you manage all your providers and services.

What is a Care Coordinator?

A. The Care Coordinator is your main contact. This person helps you manage all of your providers, services and makes sure you get what you need. The member and/or caregiver may request a change in the Care Coordinator assigned, as needed, by calling the Care Coordinator or Member Services. Additionally, Molina staff may make changes to the member’s Care Coordinator assignment based upon the member’s needs (cultural / linguistic / physical / behavioral health) or location. Contact your Care Coordinator at (855) 735-5604 from 8:30 a.m. to 5 p.m., Monday through Friday.

How do I reach my Care Coordinator?

A. You can reach your Care Coordinator at (855) 735-5604 from 8:30 a.m. to 5 p.m., Monday through Friday.

How do I find out if a health care service or benefit is covered?

A. Go to Summary of Benefits to find out about your benefits and services. You can also call Member Services at (855) 735-5604 from 8 a.m. to 8 p.m., Monday through Friday.

What drugs are covered? Are my drugs covered?

A. To find out what drugs are covered under your plan, view the Molina Healthcare Drug List (Formulary) for your plan under Prescription Drugs.

What kind of transportation do I get? Who do I contact if I need help with transportation?

A. Go to Transportation to find out more information about non-emergency transportation to get you to and from plan-approved healthcare locations. You can also call Member Services at (855) 735-5604 from 8 a.m. to 8 p.m., Monday through Friday.

Are there any health and wellness benefits or additional services available to me?

A. Yes, Molina offers services related to your health and wellness needs. We are able to help you identify services that will benefit you and your quality of life. Speak with your Care Coordinator for more information, or you can contact our Member Services Department at (855) 735-5604 from 8 a.m. to 8 p.m., Monday through Friday.

What if I’m enrolled in a plan, but my PCP isn’t in the network?

A. People who are enrolled in MI Health Link plan have the right to continue to see providers who are not in the health plan’s network during the 90-day Continuity of Care period. Communication between the enrollee, providers and the health plan is essential to ensure providers are identified so service can be provided and covered by the health plan. The health plan must work to bring enrollee’s current providers into the health plan’s network. Contact your Care Coordinator with questions on the Continuity of Care period.

How do I change my primary care provider (PCP)?

A. There are two ways you can change your PCP.

• Go to MyMolina and follow the instructions. If you have not registered for MyMolina yet, you can do it online today.
• You can also call Member Services at (855) 735-5604 from 8 a.m. to 8 p.m., Monday through Friday.

How can I get Molina Healthcare material translated in my preferred language?

You can get member materials in any language you need, such as English, Arabic or Spanish, at no cost to you. You can also get this information for free in other formats, such as large print, braille or audio. If you need your health plan information in a different language or format, call Member Services at (855) 735-5604 from 8 a.m. to 8 p.m., Monday through Friday. The call is free.

What does my Member ID card look like?

A. This is what your Member ID card looks like. You will no longer need to carry both your Medicare ID card and your Medicaid information when getting medical services. Now all the information you need to show you qualify for benefits will be on just one card. Your ID card will also include important phone numbers and prescription information to help you get your medicine. If your plan membership card is damaged, lost, stolen or if you want more information, call Member Services at (855) 735-5604 from 8 a.m. to 8 p.m., Monday through Friday. We will send you a new one. You can also request for a new card online on the MyMolina portal.

What is an Integrated Care Plan?

A. An Integrated Care Plan (ICP) is the plan used to identify what supports and services you will get and how you will get them. Your care coordinator will help set this up for you. Together, you and your care team will make a care plan. You will receive an initial assessment at time of enrollment to assess your current health, welfare and functional needs. This assessment will be used to determine if referrals for long term care or behavioral health are needed and will be used to develop an individualized care plan. You will receive an assessment every twelve (12) months and at specific intervals based on your individual needs. If you have more complex needs, you will receive additional contacts to update your individualized care plan on a regular basis. You will also receive a reassessment when there is a change in your health status or needs; examples include: hospital admissions, a loss or change in caregiver or upon your request. Your care plan will be updated based on the reassessment. Assessments may be conducted in person if you have immediate or multiple needs. The ICP is available for download on the MyMolina portal.

Which behavioral health benefits are covered? Are these benefits available in my area?

A. Behavioral health benefits are available to Molina Dual Options MI Health Link members through the local Prepaid Inpatient Health Plan (PIHP) provider network. Some of the benefits include:

• Outpatient therapy visits
• Inpatient behavioral health care
• Outpatient substance use disorder services
• Partial hospitalization services

For a full list of benefits, please check the Summary of Benefits or contact your Care Coordinator.
These benefits are available in both Wayne and Macomb County. If you live in Wayne County, please contact "Detroit Wayne Integrated Health Network at (313) 344-9099 from 8 a.m. – 4:30 p.m. EST, Monday through Friday. If you live in Macomb County, please contact Macomb County Community Mental Health at (855) 996-2264 from 8 a.m. – 8 p.m. EST, Monday through Friday.

How can I identify a fiscal intermediary?

A. The plan will pay for a fiscal intermediary (FI) to assist you to live independently in the community while you control your individual budget and choose the staff to work with you. The FI helps you to manage and distribute funds contained in the individual budget. You use these funds to purchase home and community based services authorized in your plan of care. You have the authority to hire the caregiver of your choice. For more information, contact your Care Coordinator.