Annual Notice of Change (ANOC)

Member Handbook
The information in this booklet is in effect from January 1, 2022 through December 31, 2022.- 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 disenroll from Molina Dual Options and other options that are available.
- Your rights and responsibilities upon disenrollment - for more information, please see Chapter 8 of the Member Handbook.
- A list of Out-of-Network Coverage Rules.
Molina Dual Options Cal MediConnect Plan Medicare-Medicaid Plan is a health plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees.
You can get this information for free in other formats, such as large print, braille, or audio. Call (855) 665-4627, TTY/TDD: 711, Monday – Friday, 8 a.m. to 8 p.m., local time. The call is free.
Limitations and restrictions may apply. For more information, call Molina Dual Options Cal MediConnect Plan Medicare-Medicaid Plan Member Services or read the Molina Dual Options Member Handbook.
Benefits and/or copayments may change on January 1 of each year.
The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. We will send you a notice before we make a change that affects you.
Molina Healthcare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-855-665-4627 (TTY: 711).
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-855-665-4627 (TTY: 711).
注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-855-665-4627(TTY:711).
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-855-665-4627 (TTY: 711).
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-855-665-4627 (TTY: 711).
주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-855-665-4627 (TTY: 711) 번으로 전화해 주십시오.
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-855-665-4627 (телетайп: 711).
ՈՒՇԱԴՐՈՒԹՅՈՒՆ՝ Եթե խոսում եք հայերեն, ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ: Զանգահարեք 1-855-665-4627 (TTY (հեռատիպ)՝ 711):
ប្រយ័ត្ន៖ បើសិនជាអ្នកនិយាយ ភាសាខ្មែរ, សេវាជំនួយផ្នែកភាសា ដោយមិនគិតឈ្នួល គឺអាចមានសំរាប់បំរើអ្នក។ ចូរ ទូរស័ព្ទ 1-855-665-4627 (TTY: 711)។
توجه: اگر به زبان فارسی گفتگو می کنید، تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با 1-855-665-4627 (TTY: 711) تماس بگیرید.
ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصلبرقم 1-855-665-4627 (رقم هاتف الصم والبكم: 117).
Plan Materials
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*Printed copies of information posted on our website are available upon request.
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