As of September 1, 2021, Magellan Complete Care of Florida (MCC of FL) will become Molina Healthcare of Florida and the MCC of FL member portal will no longer be in service. To set up your new Molina member portal,

please visit

Provider Forms

Authorization Forms

Behavioral Health – Prior Authorization Form

General Rx – Prior Authorization Form

Medical Services – Prior Authorization Form

Radiology Authorization Online Form

Residential Psychiatric Treatment Authorization Form

Synagis – Weight Change/Prior Authorization Form

Medical Forms

Adult Health Assessment Form

Child Health Assessment Form

Request Form for Multi-Source Brand Drug

SIPP/STGC Discharge Notification Form

Health Information Forms

AUD Consent Form (Ongoing sharing of information)

AUD Consent Form (Release for specific information)

Appeals Forms

Provider Appeal Form

Prescription Drug Forms

Antidepressants – Under 6 years of age

Antipsychotic – Under 6 years of age

Antipsychotic – 6 to under 18 years of age

Adult Antipsychotic- High dose

Human Growth Hormone Diagnosis

Multi-source brand

Neupogen Leukine Neulasta Diagnosis

For Magellan Complete Care of Florida Pharmacy prior authorizations, please fax or mail completed forms to:

Magellan Complete Care of Florida
c/o Magellan Pharmacy Solutions
11013 West Broad Street
Suite 500
Glen Allen, VA 23060

Fax: 800-424-7982
Phone: 800-327-8613 (TTY 711)