2010 Molina Medicare Options (HMO) Evidence of Coverage
The information in this booklet is in effect from January 1, 2010 through December 31, 2010.

The EOC, along with your enrollment form, is Molina’s contract with you. These documents explain your rights, benefits, and responsibilities as a member of Molina Medicare. They also explain our responsibilities to you, as well as outline the following details:

• What is covered and what is not covered.
• How to get the care you need, including rules you must follow.
• What you pay for your health plan.
• Your rights as a member of our plan, including treatment decisions and using advance directives.
• What to do if you are unhappy about something related to getting your covered services.
• Our responsibility to treat patients with dignity, fairness and respect.
• How to disenrollment from Molina Medicare and other options that are available.
• Your rights and responsibilities upon disenrollment.

If you would like to receive this booklet in a different format (such as Spanish), please contact us at 866-403-8293 (TDD/TTY 800-346-4128) Monday - Sunday, 8:00 AM - 8:00 PM local time.