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Did you know that when you join Molina Healthcare you have certain rights and responsibilities? Knowing your rights and responsibilities will help you, your family, your provider and Molina Healthcare ensure that you get the covered services and care that you need.

Being treated with courtesy and respect
As a Molina Healthcare of Wisconsin member, you have the right to be treated with courtesy and respect. When you call us, we try very hard to treat you with kindness and empathy. It is very important to us that you feel valued and heard. In fact, we must obey laws that protect you from discrimination and unfair treatment. 

If you ever feel like you are not being treated with courtesy and respect by your provider or anyone on the Molina team, please call (888) 999-2404 and ask to speak with the Molina Member Advocate. Your advocate will make sure your concerns are resolved quickly and fairly. You can also read more about your rights in the Molina Member Handbook.

You have the following rights:

• To receive the facts about Molina Healthcare, our services and providers who contract with us to provide services.
• Have privacy and be treated with respect and dignity.
• Help make decisions about your health care. You may refuse treatment.
• Request and receive a copy of your medical records or request an amendment or correction.
• Openly discuss your treatment options in a way you understand them. It does not matter what the cost or benefit coverage.
• Voice any complaints or appeals about Molina Healthcare or the care you were given.
• Use your member rights without fear of negative results.
• Receive the members’ rights and responsibilities at least yearly.
• Suggest changes to this policy.
• You have the right to ask for an interpreter and have one provided to you during any BadgerCare Plus and/or Medicaid SSI covered service.
• All covered services must be available and accessible to you. When medically appropriate, services must be available 24 hours a day, seven (7) days a week.
• You have the right to be free from any form of restraint or seclusion used as a means of force, control, ease or reprisal.
• You have the right to receive information about your treatment options including the right to receive a second opinion.
• You have the right to an independent review of any final decisions regarding your health care made by the plan.
• You have the right to receive information in the Member Services Handbook in another language or another format.
• You have the right to receive health care services as provided for in Federal and State law.
• You have the right to make decisions about your health care.

*Subject to State and Federal laws.

Member Responsibilities

• Give, if possible, all facts that Molina Healthcare and the providers need to care for you.
• Know your health problems and take part in making agreed upon treatment goals as much as possible.
• Follow the care plan instructions for care you agree to with your provider.
• Keep appointments and be on time. If you are going to be late or cannot keep an appointment, call your provider.

The Molina Healthcare of Wisconsin, Inc. Well-Care Visit Sweepstakes Official Rules

NO PURCHASE OR PAYMENT OF ANY KIND NECESSARY TO ENTER OR WIN THE SWEEPSTAKES. PURCHASE WILL NOT INCREASE YOUR CHANCES OF WINNING. VOID WHERE PROHIBITED OR OTHERWISE RESTRICTED BY LAW.

1. ELIGIBILITY: The Molina Healthcare of Wisconsin, Inc. Well-Care Visit Sweepstakes (the “Sweepstakes”) is open only to legal residents of Wisconsin who are BadgerCare Plus Molina members between twelve (12) and twenty-one (21) years of age at the time of entry, and for those individuals below eighteen (18) years of age, have written consent of a parent or legal guardian. Void in all other jurisdictions and where prohibited by law. Entrants below eighteen (18) years of age must have written parental/legal guardian consent to participate.   Employees, contractors, directors, agents and officers of Molina Healthcare (“Sponsor”), its and their parent, affiliates, subsidiaries, distributors, sales representatives, retailers, and advertising, promotion and judging agencies, and all other service agencies involved with the Sweepstakes, and members of the immediate family (spouse, parent, child, sibling and their respective spouse(s)) and household members of each such employee are not eligible to participate.  By participating, entrants agree to these Official Rules and the decisions of the Sponsor, which are final and binding in all matters relating to this Sweepstakes.  Winning a Prize (as defined below) is contingent upon fulfilling all requirements set forth herein.
2. TIMING: The Sweepstakes begins on November 4, 2024 at 12:00 a.m. Central Time (“CT”) and ends on December 31, 2024 at 11:59:59 p.m. CT (the “Sweepstakes Period”). 
3. TO ENTER: During the Sweepstakes Period, enter the Sweepstakes in one of the following ways:

   LIMIT: ONE (1) ENTRY PER PERSON, REGARDLESS OF METHOD OF ENTRY.  Entries received before or after the Sweepstakes Period will not be accepted or be eligible to win the Prize.  Any attempt by any entrant to obtain more than the stated number of entries by using multiple/different email accounts, identities, registrations and logins, or any other methods will void that entrant's entries and that entrant may be disqualified from the entire Sweepstakes.  Use of any automated system to participate is prohibited and will result in disqualification.  In the event of a dispute as to any registration, the authorized account holder associated with the Medicaid ID used to register will be deemed to be the registrant.  The potential winner may be required to show proof of being the authorized account holder of the Medicaid ID associated with the winning entry.

   Well-Care Visit Method of Entry: Complete a well-care visit with your Molina Healthcare in-network doctor and complete the entry form provided via mail with all required information and mail it in the envelope provided with pre-paid postage already affixed to: Molina Healthcare of Wisconsin, Inc., PO Box 242480, Attn: Quality Team, Milwaukee, WI 53224 (the “Address”). Any entry with incomplete information may be considered void as determined in Sponsor’s sole discretion. Entries must be post-marked by December 31, 2024 and received by January 7, 2025. By completing a well-care visit and the entry form as set forth herein, eligible entrants will receive one (1) entry into the Sweepstakes.

   1. Mail-In Method of Entry (Without Well-Care Visit): To enter without completing a well-care visit, complete the entry form you received in the mail, including your name, Medicaid ID #, date of birth, gift card choice, and address, and mail the entry form in the envelope provided with pre-paid postage already affixed to the Address set forth in Section 3(a) above (a “Mail-in Entry”). Any Mail-in Entry with incomplete information will be considered void. All Mail-in Entries must be post-marked by December 31, 2024 and received by January 7, 2025. Once submitted, all entries/entry information become the exclusive property of Sponsor and will not be acknowledged or returned.

       

4. WINNER SELECTION: On or about January 7, 2025, Sponsor will randomly select up to five (5) potential winners from among all eligible entries received during the Sweepstakes Period. AN ENTRANT IS NOT A WINNER OF ANY PRIZE, EVEN IF THE SWEEPSTAKES SHOULD SO INDICATE, UNLESS AND UNTIL ENTRANT’S ELIGIBILITY AND COMPLIANCE WITH THE OFFICIAL RULES HAVE BEEN VERIFIED AND ENTRANT HAS BEEN NOTIFIED THAT VERIFICATION IS COMPLETE.  The potential winners will be notified by email using the contact information provided during entry. If a potential winner does not have an email address, the potential winner will be notified by telephone. Within fifteen (15) days following the date of notification, each potential winner must: (a) provide a physical address and/or email address to deliver the Prize; and (b) complete, sign and return as instructed an Affidavit of Eligibility/Release and, where permitted by law, a Publicity Release (collectively, the “Winner Documents”). If a potential winner cannot be reached (regardless of reason), does not respond within the designated time, or any Prize notification is returned as undeliverable, or declines the Prize for any reason prior to award (including, but not limited to, tax implications and/or Medicaid eligibility that may be affected from receiving the Prize), the potential winner forfeits the Prize and Sponsor may award the Prize to an alternate winner selected by a random drawing from among all remaining eligible entries received.  Up to three (3) alternate drawings will be held, after which the Prize will remain un-awarded. Upon disqualification, no further compensation will be given.  Failure to comply with any term or condition in these Official Rules may result in disqualification at Sponsor’s sole discretion.  Odds of winning the Prize as set forth in Section 5 below will depend upon the total number of eligible entries received.
5. PRIZES & APPROXIMATE RETAIL VALUES: Up to five (5) winners will each receive a $100 gift card (collectively, the “Prize”). Total ARV of all Prizes awarded in this Sweepstakes: $500.00.

   Prize Restrictions: Limit: one (1) Prize per person.  Any details requested by Sponsor must be valid and accurate. Providing inaccurate, deceptive or false information may result in disqualification of the Prize winner, at Sponsor’s sole discretion. No substitution or exchange of Prize is permitted, except by Sponsor as set forth below; provided, however, prizes won by an eligible entrant who is a minor in their state of residence will be awarded to minor’s parent or legal guardian. Each winner agrees that the Prize is personal to the winner and may not be sold, resold, auctioned, bartered, assigned, exchanged, placed in commerce, transferred, given away, donated, or otherwise conveyed. The value of the Prize may be taxable as income to the winner, which may affect the winner’s income taxes and/or Medicaid eligibility.  Prize consists of only those items specifically stated as part of the Prize. All expenses and costs associated with the acceptance or use of the Prize that are not expressly specified in these Official Rules as being part of the Prize are the sole responsibility of the winner.  Sponsor reserves the right to substitute the Prize with a prize of equal or greater value in its sole discretion. Winner will not receive compensation from Sponsor for Prize items that the winner is unable to use. Winner is solely responsible for reporting and paying any and all applicable taxes. You must contact your own tax advisor for any questions concerning taxes. Sponsor’s only obligation is to award the Prize pursuant to these Rules.

6. PUBLICITY: Acceptance of the Prize constitutes permission to the Sponsor and its agents to use the winner’s name and/or likenesses, image, Prize information, photograph, voice, comments and other indicia for purposes of advertising and trade without further notice, permission, or compensation, unless prohibited by law.  If requested, entrant will sign and return a publicity release and such other documents as may be required pursuant to these Official Rules. If an entrant is a minor in their jurisdiction of residence, their parent or legal guardian will be required to sign such publicity release or other documents.
7. RELEASE OF LIABILITY: By participating in this Sweepstakes, entrants (or such entrant’s parent or legal guardian if such entrant is a minor in their jurisdiction of residence) agree to release and hold harmless Sponsor, Ascension All Saints Family Health Center, Milwaukee Health Department and each of their respective parent companies, subsidiaries, affiliates, advertising/promotion agencies, and each of their shareholders, partners, members, directors, officers, employees, franchisees, and agents (“Released Parties”) from and against any claim or cause of action, including, but not limited to, personal injury, illness,  death, or damage to or loss of property, change in Medicaid eligibility status, arising out of participation in the Sweepstakes or receipt or use or misuse of the Prize, including any travel related thereto, and for claims based on publicity rights and intellectual property rights, defamation or invasion of privacy.

8. GENERAL CONDITIONS:  If, for any reason, the Sweepstakes is not capable of running as planned, Sponsor may, in its sole discretion, void any suspect entries and (i) cancel or terminate the Sweepstakes; (ii) modify or suspend the Sweepstakes to address the impairment and then resume the Sweepstakes in a manner that best conforms to the spirit of these Official Rules; and/or (iii) award the applicable Prize in accordance with the winner selection criteria set forth above from among all eligible, non-suspect entries received.  Sponsor reserves the right, in its sole discretion, to disqualify any individual it finds to be tampering with the entry process or the operation of the Sweepstakes or to be acting in violation of the Official Rules of this or any other promotion or in an unsportsmanlike or disruptive manner.  Any attempt by any person to deliberately undermine the legitimate operation of the Sweepstakes may be a violation of criminal and civil law, and, should such an attempt be made, Sponsor reserve the right to seek damages from any such person to the fullest extent permitted by law.  Sponsor's failure to enforce any term of these Official Rules shall not constitute a waiver of that provision.

9. LIMITATIONS OF LIABILITY:  The Released Parties are not responsible for: (1) any incorrect or inaccurate information, whether caused by entrants, printing errors or by any of the equipment or programming associated with or utilized in the Sweepstakes; (2) technical failures of any kind, including, but not limited to malfunctions, interruptions, or disconnections in cellular networks, phone lines or network hardware or software; (3) unauthorized human intervention in any part of the entry process or the Sweepstakes; (4) technical or human error which may occur in the administration of the Sweepstakes or the processing of entries; (5) late, lost, undeliverable, incomplete, damaged, illegible, mutilated, destroyed, invalid, unintelligible, misdirected or stolen entries/mail; or (6) any injury or damage to persons or property which may be caused, directly or indirectly, in whole or in part, from entrant’s participation in the Sweepstakes or receipt or use or misuse of any Prize.  If for any reason an entrant's entry is confirmed to have been erroneously deleted, lost, or otherwise destroyed or corrupted, entrant’s sole remedy is another entry in the Sweepstakes, if it is possible. If the Sweepstakes, or any part of it, is discontinued for any reason, Sponsor, in its sole discretion, may elect to hold a random drawing from among all eligible entries received up to the date of discontinuance for any or all of the Prizes offered herein.  No more than the stated number of Prizes will be awarded.  In the event that production, technical, seeding, programming or any other reasons cause more than the stated number of Prizes as set forth in these Official Rules to be available and/or claimed, Sponsor reserves the right to award only the stated number of Prizes by a random drawing among all legitimate, un-awarded, eligible Prize claims.

10. DISPUTES:  Except where prohibited, all entrants (or if entrant is a minor in their jurisdiction of residence, the parent or legal guardian of such entrant) agree that: (1) any and all disputes, claims and causes of action arising out of or connected with the Sweepstakes or any Prize shall be resolved individually, without resort to any form of class action, and exclusively by the federal or state courts located in the State of Wisconsin; (2) any and all claims, judgments and awards shall be limited to actual out-of-pocket costs incurred, including costs associated with entering this Sweepstakes, but in no event attorneys’ fees; and (3) under no circumstances will entrants be permitted to obtain awards for, and entrants hereby waive all rights to claim, indirect, punitive, incidental and consequential damages and any other damages, other than for actual out-of-pocket expenses, and any and all rights to have damages multiplied or otherwise increased.  SOME JURISDICTIONS DO NOT ALLOW THE LIMITATION OR EXCLUSION OF LIABILITY FOR INCIDENTAL OR CONSEQUENTIAL DAMAGES, SO THE ABOVE MAY NOT APPLY TO YOU.  All issues and questions concerning the construction, validity, interpretation and enforceability of these Official Rules, or the rights and obligations of the entrant and Sponsor in connection with the Sweepstakes, shall be governed by, and construed in accordance with, the laws of the State of Wisconsin without giving effect to any conflict of law rules (whether of the State of Wisconsin or any other jurisdiction), which would cause the application of the laws of any jurisdiction other than the State of Wisconsin.
11. PRIVACY: All information submitted to Sponsor as part of a Sweepstakes will be treated in accordance with Sponsor's privacy policy, available at MolinaHealthcare.com and these Official Rules.  If you are selected as a winner, your personal information may be included on a publicly-available winners’ list. 
12. WINNERS’ LIST: For the names of the winners, send an email with subject line “Molina Healthcare of Wisconsin, Inc. Well-Care Visit Sweepstakes” Winners’ List, to MHWIQuality@molinahealthcare.com. Requests for winners’ list must be received within ninety (90) days after the Sweepstakes Period.
13. SPONSOR: Molina Healthcare of Wisconsin, Inc., PO Box 242480, Milwaukee, WI 53224.

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