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Molina Healthcare Medicaid, CHIP, & Medicare of Texas

Molina Healthcare Medicaid, CHIP, & Medicare of Texas 2025

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The document is a Prior Authorization/Pre-Service Review Guide for Molina Healthcare's Medicaid, CHIP, and Medicare members in Texas, effective from January 1, 2015. It outlines the services that require prior authorization, including various medical treatments, behavioral health services, and durable medical equipment. The guide specifies that referrals to network specialists and office visits to contracted providers do not need prior authorization. It also provides contact information for various authorizations and emphasizes the importance of submitting adequate patient history and relevant documentation for authorization requests.

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Click ‘Get Form’ to open the Molina Healthcare Medicaid, CHIP, & Medicare Prior Authorization Request Form in the editor.
Begin by filling out the 'MEMBER INFORMATION' section. Enter the date of request, select the plan (Molina Medicaid or Molina Medicare), and provide the member's name and ID number.
Specify the service type as either Elective/Routine or Other. Include the member's date of birth and phone number.
Indicate if the request is Expedited/Urgent by checking the appropriate box and providing a brief explanation if necessary.
In the 'Referral/Service Type Requested' section, select from options such as Inpatient, Outpatient, or Surgical procedures. Fill in relevant details like diagnosis code and CPT/HCPC code.
Complete the 'PROVIDER INFORMATION' section with details about the requesting provider and facility providing service, including contact information.
Attach any clinical notes and supporting documentation before submitting your form for processing.

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Versions	Form popularity	Fillable & printable
2017	4.3 Satisfied (43 Votes)
2015	4.5 Satisfied (60 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What are the disadvantages of CHIP insurance?

Weaknesses of the Program This financial uncertainty prevents states from making improvements. Children are left uninsured for a period of time due to waiting periods and lock-outs in some states. Higher cost-sharing requirements and high charges of premiums by separate CHIP programs can diminish access to healthcare.

What is Molina CHIP?

Mississippi CHIP is a state health insurance plan for children. Depending on income and family size, working Mississippi families who do not have other health insurance may qualify for CHIP. Learn More.

Is CHIP insurance the same as Medicaid?

Children eligible for CHIP are in families with incomes too high to qualify for Medicaid, but too low to afford private coverage. Both Medicaid and CHIP are administered by states ing to federal requirements and are funded jointly by states and the federal government.

What are the two types of Medicaid in Texas?

In Texas, there are 5 different types of Medicaid: Traditional Medicaid. STAR. STAR Kids. STAR Health. STAR+PLUS.

What is the difference between CHIP and Medicaid Texas?

Childrens Medicaid is a health care program for children in low-income families. CHIP is a health care program for children without health insurance whose families earn too much to get Medicaid but cannot afford health insurance.

What is the difference between CHIP and Medicaid in Texas?

Childrens Medicaid is free. If we find your child is eligible for Childrens Medicaid, there is no cost to receive services. CHIP fees vary based on your income. If we find your child is eligible for CHIP, your enrollment fee and co-pays will be based on your familys income.

Is CHIP covered by Medicaid or Medicare?

The Childrens Health Insurance Program (CHIP): Provides health coverage to eligible children through both Medicaid and separate CHIP programs. Children eligible for CHIP are in families with incomes too high to qualify for Medicaid, but too low to afford private coverage.

Is Molina Healthcare Medicaid or Medicare in Texas?

Explore your Molina Healthcare of Texas Medicaid Program The quality health plan you can afford. Learn more about your health plan, whats covered and the many programs we offer.

Molina Healthcare Medicaid, CHIP, & Medicare of Texas 2025

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