Molina Matters: Scope of Appointment Forms

Scope of Appointment Forms

Just a reminder that Scope of Appointment forms must be completed and recorded with the beneficiary 48 hours before the marketing appointment. For 2025, Molina has seven (7) different Scope of Appointment forms to choose from when working with beneficiaries. All are available in both English and Spanish. Be sure to use the appropriate version to each situation. These forms may be found on the Molina Agent Center under the 2026 Medicare Enrollment Toolkit.

Availble forms include: 

• Molina Universal
• Massachusetts 2224
• Massachusetts 4371
• Molina California
• Central Health Plan
• New Mexico
• Washington

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