Molina Medicare Options (HMO)

Molina Medicare Options (HMO) is a Medicare Advantage Prescription Drug plan for people with Medicare. You are eligible for Molina Medicare Options (HMO) if you:

Are entitled to Medicare Part A, and;
Are enrolled in Medicare Part B and continue to pay your Medicare Part B premium, if not otherwise paid for under Medicaid or by another third party
Reside in the Molina service area

To find out more about Molina Medicare Options (HMO) plan benefits, please click on the Plan Materials in the left hand column. They include:

Enrollment form - Please complete this form to enroll in the plan. If you need help in completing the form, please contact Molina Medicare at
1-866-403-8293 (TDD/TTY: 1-800-346-4128) Monday - Sunday, 8:00 AM to 8:00 PM local time. You may only enroll in Molina Medicare Options (HMO) at certain times of the year.*
Evidence of Coverage (EOC) - The EOC explains your rights, benefits, and responsibilities as a member of Molina Medicare. It also explains our responsibilities to you.
Summary of Benefits (SB) - The SB outlines your plan premium, benefits, co-payments and coinsurance for the current calendar year.
LIS Chart - This chart shows you what your monthly plan premium will be if you get extra help from Medicare in paying certain prescription drug costs.
Full Privacy - This notice describes how medical information about you may be used and disclosed. It also explains how you can get access to this information.
Contact HIPAA - HIPAA, which stands for the American Health Insurance Portability and Accountability Act of 1996, is a set of rules to be followed by doctors, hospitals and other health care providers. This link provides information on how to contact the HIPAA office in your state.

*You may switch plans during the Annual Enrollment Period from November 15th through December 31st of any year. During the Open Enrollment Period, you may also switch from one "like" plan to another from January 1st to March 31st of any year, but you cannot add or drop Medicare prescription drug coverage during this time.

Disclaimer Information:

Molina Medicare Options HMO, SmartSaver HMO, Healthy Advantage HMO, ChoicePartners Medicare HMO are Medicare Advantage Prescription Drug plan(s) (MAPD).

Molina Medicare Options Plus HMO, Healthy Advantage HMO are Medicare Advantage Prescription Drug Special Needs plan(s) (MAPD-SNP). This plan is available to anyone who Medical Assistance from the State and Medicare.

All Medicare beneficiaries entitled to Medicare Part A and enrolled in Part B may apply. Members must reside in the Molina service area and continue to pay their Medicare Part B premium if not otherwise paid for under Medicaid or by another third-party.

You must use plan providers except in an emergency or urgent care situations or for out of area renal dialysis. If you obtain routine care from out-of-network providers, neither Medicare nor Molina Medicare and Healthy Advantage will be responsible for the costs. If you decide to switch to premium withhold or move from premium withhold to direct bill, it could take up to three months for it take effect and you will ultimately be held responsible for those premiums.

Molina’s contract with Centers for Medicare and Medicaid Services (CMS) is renewed annually and availability of coverage beyond the end of the current contract year is not guaranteed. Reductions in the service area or contracted provider network may limit a member’s access to enroll or limit access to providers. Medicare Advantage Prescription Drug Special Needs plan(s) (MAPD-SNP) can enroll anytime, while Medicare Advantage Prescription Drug plan(s) (MAPD) ability to enroll may be limited to certain times of the year. Medicare beneficiaries may enroll in Molina Medicare and Healthy Advantage through the Centers for Medicare and Medicaid Services Online Enrollment Center, located at hhtp:www.medicare.gov. For more information contact the Molina Medicare at 1-866-403-8293 or TTY users call 1-800-346-4128.

The Medicare program rates how well plan perform in different categories (for example, detecting and preventing illness, ratings from patients and customer service). If you have access to the web, you may use the web tools on www.medicare.gov and select “Compare Medicare Prescriptions Drug Plans” or “Compare Health Plans and Medigap Policies in Your Area” to compare the plan ratings for Medicare plans in your area. You can also call us directly at 1-866-403-8293 or TTY users call 1-800-346-4128 to obtain a copy of the plan ratings for this plan. Members must receive their Medicare Prescription Drug Benefit through the plan and the prescription drug benefit is only available to plan members. You must use network pharmacies to access your prescription drug benefit, except under non-routine circumstances when you cannot reasonably use network pharmacies. For benefits with exclusions and limitations please see our plan specific details at www.molinamedicare.com. For more information, please contact Molina Healthcare at 1-866-403-8293 (TTY: 1-800-346-4128), Monday – Sunday, 8:00 AM to 8:00 PM local time. Important plan information.

People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If eligible, Medicare could pay for seventy-five percent of drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of help you may receive; for more information, please contact the plan. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. To see if you qualify for getting extra help for your prescription drug premiums and costs, call: 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week; the Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call-1-800-325-0778; or your State Medicaid Office. These plan(s) are offered by Molina Healthcare, a health plan with a Medicare contract.