Molina Medicare Advantage - Medicaid Dual Eligible - How to begin using your plan - YouTube

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[puzzle pieces snapping together]

Welcome to the final video in the  Molina Healthcare Medicare series.  

You're almost ready for the finishing pieces  of your Medicare Advantage puzzle.

Moving the finishing pieces into your puzzle means preparing  for day one with your Molina health plan.

So let's talk about what you can expect whether 

you're a new member or have  been with us for a while.

The most important thing to know is you can access and use all of your benefits right from the start.

Your MyMolina member portal, Summary  of Benefits, and Evidence of Coverage

are all great resources when you have questions  about your Molina health plan or benefits.

Now that your new plan year  has started, it's time to 

take advantage of no cost preventative  care to start it off right.

A preventative care appointment with your  Primary Care Provider, or PCP for short, 

is a great way to stay up to date  on important health screenings.

These include cancer or diabetes screenings.

You can also schedule an appointment  to get important vaccines 

for the flu, Shingles,  Pneumonia, Hepatitis B, and more.

The start of a new plan year  helps you stay on schedule 

especially if you're managing a  chronic or serious health condition.  

You might need to schedule  routine visits with your doctor. 

If so, call member services and  we'll help you schedule them.

If you've already scheduled a routine visit, 

make sure you take your Molina  member id card with you.

Telehealth, or virtual visits,  are options in many cases.

You might be thinking, what happens if I  have a medical question but it's after hours?

Don't worry, we've got you covered.

You can always call the 24 hour nurse advice line at (888) 275-8750,

or 711 for the hearing impaired, 24 hours  a day 7 days a week and talk to a nurse.  

They can help you get the care you need  and answer any medical questions you have.  

Let's talk a little bit about  any medications you take.

If you take daily medications and  will need them refilled be sure 

to check your Provider Directory  before heading to the pharmacy.  

You'll need to make sure your  pharmacy is in Molina's network.

We have plenty of network  pharmacies you can choose from. 

You can also find a list in  the MyMolina member portal.  

If your pharmacy isn't in our network use  our provider online directory to find one.  

You can work with your new pharmacy to set up  a prescription transfer for your medications.

We update our formulary or drug list often  so it's also a good idea to check and make  

sure your drug is covered. Talk to your  doctor or Molina's pharmacy services team  

about requesting mail-order prescriptions  covering a 90-day supply of your medications.

Many people find this to be a great option for getting their medications and saving money.

Do you need a ride to your  appointment or the pharmacy? 

Molina can help with that!

Many of our medicare advantage plans offer 

transportation services for  covered medical services.

If you need a ride make sure you  call at least 48 hours in advance.

Be aware that some health plans  have mileage rules or annual  

limits on the number of trips you can request.

Other plans might have a flexible debit  card that's used just for transportation.

Refer to your EOC and Summary  of Benefits for details 

about transportation benefits that  are specific to your health plan.

Your Molina health plan might offer  other supplemental benefits as well.

Be sure to learn more about them so you  can start using them as soon as possible.

Some health plans use the MyChoice flexible  debit card to pay for these benefits.

Other plans might offer different  ways to access, use, and pay for them.

Refer to your EOC and Summary of Benefits or  call member services if you have any questions.

Let's take a closer look  at some of the most common 

supplemental benefits that  might be available to you.

We know good oral health is important  to your overall physical health.

That's why we include dental cleanings as  part of your no-cost preventative care.

As a dual-eligible member,  

you'll get your dental benefits from  the Medicaid part of your health plan.

Before making your appointment make sure you  check out your health plan's dental benefits

as there might be other dental  procedures that are covered.

Remember, some health plans might use a  flexible debit card for dental benefits,  

others will have a specific  dental card from a dental vendor.

Be sure to check with your health plan if  you have any questions about dental benefits.  

Vision care is another supplemental benefit  we should add to your puzzle. Molina's vision  

partner provides vision benefits including annual  exams and an allowance for frames and lenses.

You might also be eligible for  a no-cost glaucoma screening.

Keep in mind that some Molina  health plans might require 

you to use your benefits at a  vision provider in their network.

Others might give you a debit card  to spend your annual allowance 

at your preferred vision provider  regardless of their network status.

A lot of Molina Medicare  Advantage plans offer quarterly 

over-the-counter benefits for  important health-related items.  

Some examples of those items include  bandages, toothpaste, diabetic socks,  

and aspirin. Let's talk a little bit more  about this third supplemental puzzle piece.

Depending on your Molina health plan, you might get an OTC catalog mailed to you.

If you're not sure if your  health plan offers this, 

give them a call and ask.

If your plan doesn't mail one out, you can still find your plan's OTC catalog online.

Be sure to review the dollar amount  you're given to use each quarter.

It's also important to know  what items are covered. 

You should spend the full dollar  amount you're given each quarter.

If you don't the unused funds  won't roll over to the new quarter.

If you have a MyChoice flexible  debit card for transportation, 

your OTC allowance is combined  with your transportation allowance.

This gives you more ways to spend your allowance.

Our hearing changes over time.

Molina partners with hearing  vendors to give you even 

more benefits than what you  would get with original Medicare.

This might include routine hearing  tests and fittings for hearing aids.

Some health plans give you  pre-selected hearing aids,  

others will give you an annual  allowance to purchase your own.

Molina recognizes that emotional and  mental health are more important than ever.

In addition to no-cost  Medicare preventative services, 

like depression screenings or in-network  mental health specialists, you might be  

able to get more behavioral health benefits from  your state Medicaid agency. Call member services  

if you have questions about this or would  like more information. We're almost there! 

Your puzzle is looking great. Let's grab  that final supplemental puzzle piece. 

This benefit is all about fitness. Being healthy  is not just about doctors’ visits and medications.  

Exercise plays a key role in your  overall health and well-being.

Molina partners with the Silver&Fit  program to offer you wellness benefits.

In addition to fitness options that  are available at the gym or at home,

a healthy aging specialist can work with you  to create a wellness plan that's just for you.

Your healthy aging specialist  might give you a home fitness kit  

to help you reach your wellness goals.

Even if you can't make it to the gym.

You can learn more about this benefit in your EOC.

Don't forget to talk to your doctor  before starting any exercise program.

These are just some of the benefits  that might be available to you.

Check your plan to see if you  have coverage for things like 

chiropractic care, acupuncture, home-delivered  meals, personal assistive devices,  

worldwide coverage for emergency or urgent  care services, member rewards, and more.

Remember some plans don't have all, or  even some, of these supplemental benefits.  

You can check your Summary of Benefits and EOC  to see what supplemental benefits are offered.

You can also call member services if you're unsure.

You might be eligible for a personal assistive device from the Personal Emergency Response System benefit.

Most of the time the device lets you speak with a live person who can help you with your emergent and non-emergent needs.

It can also help you when you simply want to speak with someone.

Now that you've enrolled with your Molina health plan,

you'll be assigned a Care Manager who can help you with setting up transportation to a medical appointment

or verifying eligibility for other benefits or  special supplemental benefits for the chronically ill.

If you have questions about your Care Manager, or would like to change Care Managers, you can give member services a call.

Within your first 90 days with your Molina health plan we'll give you a call to complete your Health Risk Assessment or HRA.

We'll ask you questions about your health so that we have  a better understanding of how we can help you.  

Some of the questions might be about your current health conditions or the last time you saw your doctor.

The call should only take 15 to 20 minutes.

We'll call you each year to complete this survey because your health might change from year to year,

and we want to make sure we have the most current information on file for you.

This will also help your doctor and Care Manager update your care plan

so they know what your most current health needs are.

You did it! Your Medicare Advantage puzzle is complete!

You're now ready to start your health journey with Molina.

Even though you've finished your puzzle,  

we're always here to help you,  even if your journey changes.

Remember you can always call member services or 

check the MyMolina portal for  helpful information and tools.

You can also re-watch any video  from this series later if you want.

We hope you've enjoyed this  onboarding video series.

Thank you for being part of the Molina family.

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