Provider Materials

Welcome to the Central Health Medicare Plan (CHMP) provider network! This page is your go-to resource for key materials, including the provider manual, important communications, and necessary forms, to help you work effectively with us.

The provider manual is your comprehensive guide to collaborating with CHMP. It outlines our policies, procedures, and regulatory requirements while offering insights into our programs and processes. This ensures we can work together seamlessly to meet our members' healthcare needs. The information provided here and in the manual is accurate as of its publication date, and updates will be made as policies or regulatory requirements evolve.

If you have any questions, our dedicated team is here to assist you. Contact us at 866-403-8296 via our new provider services line, email us at PRCalifornia@molinahealthcare.com, or reach out to your regional Provider Service Representative. We look forward to partnering with you!

Key Materials

2026 Provider Manual

2026 Provider Manual Update

Quick Reference Guide

Provider Training

2026 Model of Care

2026 Model of Care Training Attestation

Eligibility (eList) List Ingestion Process

Provider Roster Submission Guide

Frequently Used Forms

CA – Complex Case Management - External CM Referral form

Prior Authorization Form

C-SNP Chronic Condition Qualification Form

Prior Authorization Guide

Provider Update

Clinic Profile

Provider Profile

Term Provider Information Sheet

Update Information Sheet

Prior Authorization Lookup Tool

* Please note that this list/lookup tool and associated statements regarding authorization requirements do not apply to services authorized by Health Plan delegates, such as Independent Physicians Association (IPAs) and medical groups. Please refer to the medical group or IPA’s website for additional information or contact your IPA for more information.

2026 Online Formulary

Central Health Medicare Plan (HMO)

Central Health Medi-Medi Plan II (HMO D-SNP)

Central Health Classic Care Plan IV (HMO)

Central Health Jade Plan (HMO)

Central Health Classic Care Plan III (HMO)

Central Health Dual Access Plan (HMO D-SNP)

Central Health Embrace Care Plan (HMO C-SNP)

Central Health Embrace Choice Plan (HMO C-SNP)

Central Health Classic Care Plan I (HMO)

Central Health Classic Care Plan II (HMO)

Central Health Part B Savings Plan (HMO)

Formulary

Central Health Medicare Plan (HMO)

English | Spanish

Central Health Medi-Medi Plan II (HMO D-SNP)

English | Spanish | Chinese | Vietnamese | Korean

Farsi | Hmong | Russian | Tagalog

Armenian | Arabic

Central Health Classic Care Plan IV (HMO)

English | Spanish

Central Health Jade Plan (HMO)

English | Spanish

Central Health Classic Care Plan III (HMO)

English | Spanish

Central Health Dual Access Plan (HMO D-SNP)

English | Spanish | Chinese | Vietnamese | Korean

Farsi | Hmong | Russian | Tagalog

Armenian | Arabic

Central Health Embrace Care Plan (HMO C-SNP)

English | Spanish

Central Health Embrace Choice Plan (HMO C-SNP)

English | Spanish

Central Health Classic Care Plan I (HMO)

English | Spanish

Central Health Classic Care Plan II (HMO)

English | Spanish

Central Health Part B Savings Plan (HMO)

English | Spanish

2026 Prior Authorization

2026 Step Therapy

Central Health Medicare Plan (HMO)

Central Health Medi-Medi Plan II (HMO D-SNP)

Central Health Classic Care Plan IV (HMO)

Central Health Jade Plan (HMO)

Central Health Classic Care Plan III (HMO)

Central Health Dual Access Plan (HMO D-SNP)

Central Health Embrace Care Plan (HMO C-SNP) 25-01

Central Health Embrace Care Plan (HMO C-SNP) 25-02

Central Health Embrace Choice Plan (HMO C-SNP) 26-01

Central Health Embrace Choice Plan (HMO C-SNP) 26-02

Central Health Embrace Choice Plan (HMO C-SNP) 26-03

Central Health Embrace Choice Plan (HMO C-SNP) 26-04

Central Health Classic Care Plan I (HMO)

Central Health Classic Care Plan II (HMO)

Central Health Part B Savings Plan (HMO)

Central Health Valor Care Plan (HMO)

RX Forms

How to Request a Redetermination

Requesting a Redetermination

Coverage Determination

Direct Member Reimbursement

Part B Step Therapy

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