Transition of Care
If you had health care services scheduled before joining Molina Dual Options, it is important that you call Member Services today or as soon as possible. We will help you get the care you need with your new plan. For a time after you join Molina Dual Options, you may be able to continue to receive care from a provider that is not in our provider network. This is called transition of care. Transition of care is important to ensure a smooth transition to our health plan and the benefits, services and prescriptions you need.
Transition of Care Time Period for Non-Waiver Members
| Service | Services you were receiving from a non-network provider at the time of your enrollment in the MyCare Ohio program will be covered from the first date of enrollment for: |
|---|---|
|
365 days except if you are identified for high risk care management then your physician must be covered for 90 days. |
| Dialysis Treatment |
90 days (or more if authorized by plan) |
|
Until the planned or authorized services are received. |
|
Medicaid Home Health and Private Duty Nursing |
90 days |
|
Assisted Living or Medicaid Nursing Facility |
Unlimited period if lived in the facility on the day you enrolled in the MyCare Ohio program and the service continues to be medically necessary. |
Transition of Care Time Period for Waiver Members
| Service | Services you were receiving from a non-network provider at the time of your enrollment in the MyCare Ohio program will be covered from the first date of enrollment for: |
|---|---|
|
365 days except if you are identified for high risk care management then your physician must be covered for 90 days. |
|
Dialysis Treatment |
90 days (or more if authorized by plan) |
|
Until the planned or authorized services are received. |
|
Medicaid Home Health and Private Duty Nursing |
365 days unless a change is required due to a health or other life event that changes your needs. |