Member Materials and Forms

Here you can find important documents about your Molina Healthcare of Virginia health plan. Click the links below for more information.

Quick Start Guides

We want to help you get the most out of your health plan. To get started, review your new member Quick Start Guide below.

 icon_pdf New Member Quick Start Guide (English)

  icon_pdf New Member Quick Start Guide (Spanish)

Member Handbook

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 Medicaid. 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 Manager if you have one.

icon_pdf Cardinal Care Member Handbook (English)

Printed copies of the Member Handbook are available free of charge upon request.

Member forms

Click on the links below to access important member forms.

Appeals forms

 

icon_pdf Member Appeals Form

 

 

Maternity

icon_pdf Your Guide to a Healthy Pregnancy
icon_pdf Doula Recommendation Form
icon_pdf Pregnancy Notification Member Form

 

 

Other materials

icon_pdf Important Update on our Non-Emergency Transportation Service

icon_pdf Medicaid Childhood Shots Schedule

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


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.

 

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