Molina Complete Care members or friends/family of MCC members who use their own vehicle to drive a member to a Medicaid-covered behavioral health, medical, or dental appointment, may be eligible for mileage reimbursement. The mileage reimbursement rate in Virginia is $0.40 per mile.
Complete the form with the below information to register as a driver:
- Contact information.
- Driver’s license.
- Vehicle insurance.
- Banking information.
Once approved, you will receive a confirmation email to the email address you used to register. If you need to update any of your driver information, please re-submit the form with your updated information.
If you have trouble viewing the form, please make sure that you are using the latest version of the Google Chrome browser. If you are still having issues, please download a printable version of the form. You may do this by visiting the Print Forms page.
To view our Mileage Reimbursement Guidelines, please download the guide from our Print Forms page.
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