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

Molina's premiums are lower than the national average across most tiers because every plan uses an HMO network, where care flows through a primary care physician who coordinates care and approves specialist referrals. In my analysis, the Gold tier is where that design pays off most clearly, $83 per month below the national average. Gold covers 80% of costs after your deductible, the second-highest share of any metal tier.   

Molina's medical care quality score is 9.13 points below the national average, and it denies more claims per 100 than most competitors. Buyers with frequent specialist needs or complex conditions will get better care continuity from another insurer. Cost-focused buyers with straightforward care needs are the ones for whom the Gold tier's $83 monthly savings hold up most clearly.

Molina Healthcare's plans cover all six standard metal tiers in 12 states. All of them are HMO plans. HMO stands for Health Maintenance Organization: you choose a primary care physician who coordinates your care and must approve referrals before you see a specialist. That coordination is why Molina's premiums are lower than the national average across most tiers.

PPO and EPO plan types are unavailable through Molina. Those plan structures allow out-of-network care and self-referral to specialists. Shoppers who stay in-network and rarely seek specialist care are the most likely to get full value from Molina's plans. Lower monthly costs are the primary gain from that trade-off.

Gold and Platinum plans carry the largest savings relative to the national average. Gold is $83 per month below average; Platinum is $146 below. The cost section below has the full breakdown by tier, including deductibles and maximum out-of-pocket limits.

Short-term health insurance, Medicare Supplement coverage and Medicare Advantage fall outside Molina's ACA marketplace plans.

Molina's premiums are lower than the national average across most metal tiers because all plans use an HMO structure, which limits covered care to in-network providers. Gold plans are $83 per month below the national average. Platinum plans are $146 below. Catastrophic coverage at $323 per month, is $63 above the national average.   

These are unsubsidized national averages. Most ACA marketplace buyers qualify for premium tax credits based on household income, which can lower monthly costs well below these figures. Use the HealthCare.gov premium estimator to see your actual cost after subsidies.   

In my analysis, Catastrophic is the one tier where Molina loses its cost advantage. Buyers under 30 in that tier should check other insurers before deciding. Beyond the premium, two numbers determine your annual cost: the deductible, which is what you pay before insurance starts, and the maximum out-of-pocket limit (MOOP), the annual ceiling on your covered medical spending.

* 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.   

On Platinum plans, the deductible is $0 and the MOOP is $5,000. Coverage applies from the first visit, and your annual liability tops out at $5,000. Catastrophic plans set both at $10,600. That tier is for people under 30 or those with a hardship exemption who want a cap on their major medical costs without paying for full coverage.

Molina Healthcare scores below the national average on all four quality dimensions tracked in MoneyGeek's analysis. Its overall Quality Rating System (QRS) score is 69.50, 9.89 points below the national average of 79.39. The largest gaps are in medical care quality and plan administration.

Molina denies nearly 1 in 4 claims, compared to fewer than 1 in 5 across the broader market. A denied claim means a potential appeal, and appeals take time. The more frequently a plan denies claims, the more work you may need to do to get covered care paid.

Member experience is where Molina holds up best. Its score of 92.21 out of 100 is close to the national average of 94.59. When you call with a billing question or need help finding a doctor, the service is likely to be responsive.

Molina Healthcare's ACA marketplace plans are available in 12 states for 2026, with 111 total plans. Its broader footprint, which includes Medicaid and Medicare Advantage coverage, covers more than 15 states. California is the only state with Platinum marketplace coverage. Plan options and metal tiers vary by state, so the options where you live may differ from the national totals.   

International coverage is absent from all Molina marketplace plans. Travel outside the U.S. requires a separate travel health insurance policy for medical emergencies.   

In our analysis, eight of Molina's 12 states limit buyers to Silver and Gold plans only. Washington is the only state with no Silver plans, offering Bronze and Gold only.

Molina announced in its February 2026 earnings report that it will exit the Medicare Advantage Part D market in 2027. Its ACA marketplace plans remain available in all 12 states for 2026, unaffected by that decision. Molina's focus is shifting toward dual-eligible members who qualify for both Medicaid and Medicare coverage.   

For 2026 star ratings, Molina's Medicare Advantage plans mostly held steady. Three improved by half a star, two dropped by the same amount. Most Molina Medicare Advantage plans fall in the 3.0 to 4.0 range for 2026, below the national average for Medicare Advantage.    

Dual-eligible buyers currently enrolled in a Molina Medicare Advantage plan will need to switch their prescription drug coverage before 2027, when Molina exits the Part D market. A standalone Part D plan or a new Medicare Advantage option will cover prescriptions from that point. ACA marketplace buyers are unaffected by this change.

Molina Healthcare marketplace plans include four member programs at no additional cost for 2026:

• Free 24/7 Telehealth (Teladoc): Virtual doctor visits are free with no copay, available 365 days a year for non-emergency care. For a minor illness, that's a $0 alternative to an urgent care visit.
• Wellness Rewards: Complete your annual wellness visit and health questionnaire to earn up to $200 in gift cards. Preventive screenings are covered at no cost.
• My Molina App: The app lets you search for in-network doctors, review claims and access your digital member ID card. You can also switch your primary care provider from your phone without calling member services.
• 24/7 Nurse Line: Registered nurses are available any time of day, in your language, to answer health questions and assess symptoms before you decide whether to seek care.

Member program availability varies by state. Contact Molina directly to confirm which benefits are included in plans where you live.  

Teladoc at $0 copay is included in plans across all tiers and includes Bronze plans averaging $466 per month. It gives the Bronze buyers the clearest practical value, since HMO cost-sharing means in-person visits carry out-of-pocket costs even within network. Replace one in-person visit per year with a free Teladoc call to reduce actual costs without changing the monthly premium.

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.

* Rates shown are actual plan premiums for the selected state and age, and will differ from the national averages in the cost table above.

Molina Healthcare has operated in the government-sponsored coverage space for decades. Its ACA marketplace business covers 12 states with 111 total plans for 2026. The company's focus on Medicaid and dual-eligible populations shapes its product design: lower premiums and HMO-managed networks. Plan options and metal tiers vary by state.   

Outside the 12 states, Molina has no ACA marketplace plans. Premium tax credits apply in every state regardless of insurer: use HealthCare.gov's estimator to check your subsidized rate before comparing carriers.

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%): 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.