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Enrollment Form

Your online enrollment form for Molina Medicare starts here.

Molina Medicare Options, SmartSaver, Healthy Advantage, and ChoicePartners Medicare are Medicare Advantage Prescription Drug plans (MAPD) offered by Molina Healthcare, a health plan with a Medicare contract. All Medicare beneficiaries entitled to Medicare Part A and enrolled in Part B may apply. You may switch plans during Annual Election Period (AEP) occurs November 15 through December 31 of every year. During the AEP eligible individuals may enroll in or disenroll from a Medicare Advantage Plan. Open Enrollment Period (OEP) occurs January 1st through March 31 of every year. Beneficiaries can switch to another Medicare Advantage Plan that has drug coverage, or switch to the Original Medicare Plan and join a Medicare Prescriptions Drug Plan. But, you cannot add or drop Medicare prescription drug coverage during this time.

Molina Medicare Options Plus and Healthy Advantage are Medicare Advantage Prescription Drug Special Needs Plans (MAPD-SNP) offered by Molina Healthcare, a health plan with a Medicare contract. All Medicare beneficiaries entitled to Medicare Part A, enrolled in Part B and eligible for full Medicaid may apply. You may enroll at any time during the year.

Members must reside in the Molina service area, continue to pay their Medicare Part B premium if not otherwise paid for under Medicaid or by another third-party, and receive all routine care from Molina plan providers. The Molina Medicare Prescription Drug Benefit is only available to members of the plan and you must receive your drug benefit through Molina, not another organization. Molina's contract with the Centers of Medicare and Medicaid Services (CMS) is renewed annually and availability of coverage beyond the end of the current contract year is not guaranteed.


To be eligible for a Molina Medicare plan, you must meet the following requirements:
  • Live in the plan-approved service area.
  • Be entitled to Medicare Part A (hospital insurance) and enrolled in Medicare Part B (medical insurance), and continue to pay your Medicare Part B premium (and Part A if applicable), if not paid for by another third party.
  • Not have end-stage renal disease (ESRD) unless you are currently a member with Molina Medicaid or if your previous Medicare Advantage Plan was terminated. An individual who receives a kidney transplant and no longer requires a regular course of dialysis to maintain life is not medically determined to have ESRD for purposes of Medicare Advantage eligibility. If a beneficiary no longer requires regular dialysis or has had a successful transplant, the beneficiary should obtain a note or records from the beneficiary's physician showing that the ESRD status has changed and submits it with the enrollment election.
  • For Molina Medicare Options Plus and Healthy Advantage, you must also be a state Medicaid recipient receiving full Medicaid benefits.
Once you know you are eligible for a Molina Medicare plan, follow these steps to enroll.
  • Select the plan that meets your needs.
  • Contact a plan representative by calling
    1-866-403-8293 Monday - Sunday,
    8:00 AM to 8:00 PM local time, to set up an appointment to visit you in your home or make a reservation to attend a seminar in your area. TDD/TTY users, please call:
    1-800-346-4128.
  • OR enroll online through the Centers for Medicare and Medicare Services (CMS) website. Follow the directions provided on the site to complete your enrollment. Please note: If you use this online enrollment process, you will be sending an actual enrollment election to join Molina Medicare.
You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call:

Medicare: 1-800-MEDICARE
(1-800-633-4227). TDD/TTY users should call 1-877-486-2048, 24 hours a day/7days a week.

Social Security Administration:
1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TDD/TTY users should call 1-800-325-0778.

Or, your State Medicaid Office at the numbers listed below.

CA: 1-916-552-9200 (TDD/TTY: not available) from 8 a.m. to 5 p.m., Monday-Friday. www.dhs.ca.gov/mcs

MI: 1-517-373-3740 (TDD/TTY: 800-649-3777) from 8 a.m. to 7 p.m., Monday-Friday. www.michigan.gov/mdch

NM: 1-888-997-2583 (TDD/TTY: not available) from 8 a.m. to 5 p.m., Monday-Friday. www.hsd.state.nm.us

OH: 1-800-324-8680 (TTY: 1-800-292-3572),
7 a.m. - 8 p.m. Monday-Friday and
8 a.m. - 5 p.m. Saturday. www.jfs.ohio.gov

TX: 1-800-252-8263 (TTY 1-512-424-6597),
8 am. - 5 p.m. Monday-Friday. www.hhsc.state.tx.us/medicaid

UT: 1-801-538-6155 (Salt Lake City area);
1-800-662-9651 (other parts of state), (TTY/TDD: not available) Monday - Wednesday, 7 a.m.-noon and 1-6 p.m. and Thursday 11 a.m. - 2 p.m. www.health.utah.gov/medicaid

WA: DSHS Constituent Services
PO Box 45130
Olympia, WA 98504-5130
1-800-737-0617
www1.dshs.wa.gov

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