Molina Healthcare Review (2026): Cost, Pros & Cons

Molina Healthcare is a regional insurer that offers HMO plans across all standard metal tiers in 12 states. Plan availability varies by location and age, so not every metal tier is offered in every market.

Molina delivers HMO plans exclusively and does not have HMO-POS, PPO, or EPO plan types. Members must generally stay within Molina’s provider network and obtain referrals from a primary care physician to see specialists. This structure keeps premiums lower but limits flexibility when seeking care. Shoppers who want broader provider access, out-of-network coverage, or self-referral to specialists should consider insurers that offer PPO or EPO plans instead.

Molina Healthcare operates in 12 states with plan availability varying by location. The company offers 111 total plans across its service areas, with the most options in Florida and Ohio. The table below shows where Molina plans are available and how many options are in each state, broken down by metal tier to help you compare coverage levels at a glance.

Molina Healthcare premiums beat national averages across most metal tiers, with Gold plans saving you $83 monthly and Platinum plans saving $146 monthly compared to other insurers. Bronze plans also cost $47 less than the national average at $466 monthly. The exception is Catastrophic coverage, which runs $63 higher than typical plans of the tier at $323 monthly.

All Molina plans use an HMO structure. Deductibles range from $0 for Platinum plans to $10,600 for Catastrophic coverage, while maximum out-of-pocket (MOOP) limits span $5,000 to $10,600 depending on your tier. Here's the complete breakdown of Molina Healthcare costs:

* Rates shown are national averages for 40-year-olds, with the exception of the Catastrophic metal level, which is for 26-year-olds. Your actual rates will vary by your age and location. Be sure to request quotes and compare multiple providers before applying for a health insurance plan.

Molina Healthcare marketplace members get access to several programs designed to keep health care affordable and convenient. Beyond standard medical coverage, Molina offers digital tools, wellness incentives and preventive care at no additional cost to help you manage your health.

• 24/7 Telehealth Services: Access free virtual doctor visits through Teladoc anytime from home with no copay. The service is available 365 days per year for non-emergency medical needs.
• Annual Wellness Visits: Get free yearly checkups with preventive screenings covered at 100%. You can earn up to $200 in gift card rewards for completing your wellness visit and health questionnaire.
• My Molina Mobile App: View benefits, find in-network doctors, access your digital member ID card and change your primary care provider. The app lets you check claims status and manage your coverage from your phone.
• 24/7 Nurse Advice Line: Speak with registered nurses anytime in your language about health concerns and symptoms. The nurse advice line handles over 500,000 calls annually from Molina members nationwide.
• Pediatric Coverage: Your children get preventive care visits at no cost, plus vision coverage including frames and lenses. Sports physicals for children and teens are also covered.
• Care Coordination Support: Get help navigating the health care system with case management for complex health conditions. Molina's care coordinators assist with scheduling appointments, coordinating between doctors and understanding your benefits.

Molina Healthcare scores below national averages on most quality benchmarks, though it stands out for member experience. Its overall Quality Rating System (QRS) score of 69.50 is nearly 10 points lower than the national average of 79.39, showing weaker performance in medical care quality and plan administration compared to typical marketplace insurers.

Molina’s average denial rate of 24% is notably higher than the 18% national average. Nearly one in four claims is denied, compared to fewer than one in five across the broader market. For shoppers, this can translate to more frequent claim reviews and a higher likelihood of needing to file appeals.

Molina performs best in member experience. Its score of 92.21 comes close to the national average of 94.59, showing strong customer service, communication, and support for enrolled members. However, medical care quality and plan administration lag more significantly, with scores of 67.47 and 75.01 vs. national averages of 76.60 and 83.91, respectively. Overall, Molina appeals to cost-conscious shoppers who value customer service, but those prioritizing care quality consistency and smoother claims processing should compare alternatives.

Compare Molina Healthcare plans across different metal tiers and coverage levels to find the option that fits your budget and health needs. Use the filters below to narrow your search by plan type, metal level or monthly premium.

We rate the best health insurance providers based on premiums, out-of-pocket expenses, customer experience, claims denial rates and plan selection.

MoneyGeek health insurance provider scores are weighted as follows:

• Affordability (60%): When scoring providers on affordability, we considered monthly premiums, deductibles, and maximum out-of-pocket (MOOP) costs. We weighted these factors as follows within the affordability score: monthly premiums (66.67%), deductible (16.67%), MOOP (16.67%).
• Customer Experience (30%): Centers for Medicare & Medicaid Services (CMS)’s Quality Rating System (QRS) overall rating for health-insurance plans. This is a 5-star rating system used to help consumers compare health plans on the Health Insurance Marketplace. Ratings are calculated based on three main categories: Medical Care, Member Experience, and Plan Administration. Providers with the highest overall rating get the highest score
• Denial Rate (10%): Denial rate is the percentage of submitted claims or applications that are rejected instead of approved. Providers with the lowest denial rate get the highest score.

Data sources

Health insurance plan and provider data was updated with the Centers for Medicare & Medicaid Services (CMS) exchange data released in October 2025 for the 2026 enrollment period as well as manual collection of health plan data from state insurance marketplaces for 22 states.

Sample consumer profile

We collected data on all available health plans for consumers ages 18, 26, 40, 50 and 60. Monthly premiums are based on a 40-year-old buyer unless otherwise noted, such as the category for seniors. We analyzed plans for each cited metal tier, which include Catastrophic, Bronze, Expanded Bronze, Silver, Gold and Platinum.