Enrollment and Renewal

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This is a solicitation for insurance and an agent may contact you.

By submitting my information via this form, I consent to having Molina Healthcare collect my personal information. I understand and agree that my information will be used and shared in accordance with Molina Healthcare's Privacy Policy and Terms of Use.

What Should I Expect?

Thank you for choosing Molina Medicare!

You have applied to join the Molina Medicare family. Here is what happens next.

  • Our Enrollment Department will review your Enrollment Form and send you a letter acknowledging receipt of your Enrollment Form.
  • Once your enrollment is accepted by CMS, we will send you a Member Welcome Kit, which will contain your Member ID Card and a confirmation of enrollment letter.

 

We’ll give you the resources you need

  • As a new member, you have Member Rights and Responsibilities. Read them today.
  • Visit Members to learn more about the many programs and services we offer you and your family.
  • You can find member materials (Formulary, Provider Directory, and Low Income Premium Summary (LIS)) on the Member Materials and Forms page.
  • Learn more about My Molina. It is our member portal where you can manage your health care online.
  • Check out Health Promotion for information and tips on how to keep you and your family well.
  • If you need help with medical benefits, call our Member Services Department.
  • If you need assistance with any formulary-related issue or simply have questions about drug coverage in general, please call our Pharmacy Call Center.