Molina Health Insurance Review

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Contributor, Benzinga
April 19, 2022
Molina
Overall Rating:

Molina Healthcare is a Fortune 500 company based in California that provides health plans under state marketplaces. It also provides healthcare services under Medicare and Medicaid. The company serves around 4.6 million people through the locally operated health plans it offers plans in 15 states.

Molina has a storied history of helping low-income patients receive healthcare regardless of their ability to pay for services.   

It encourages diversity, equity and inclusiveness by offering a program to certify suppliers who are friendly toward women, minorities, veterans and others living with disabilities as well as the LGBT community. 

Best For
  • Low income families
  • Preventative care
Pros
  • 3 to 4 tiers of health insurance plans
  • Competitive quotes
  • Focus on wellness
Cons
  • Customer service could be better
  • Not available in all states

Molina Ratings at a Glance

Insurance Policy Options
Insurance Customer Service
Insurance Pricing
Insurance Application Experience
Health Insurance Overall

Molina Insurance Policy Options

Molina strictly offers health-maintenance organization (HMO) health insurance plans, but this is not a downside because it’s common for health providers to offer only one option. However, this is a powerful tool that helps you access health care. Remember, some people might need more options for health coverage, but many others will feel that this health care plan is perfect for them.

Offers HMO?Yes
Offers PPO?No
Offers EPO?No
Offers POS?No

Molina offers a variety of health insurance options from minimum coverage to platinum plans. In most states, consumers can choose a bronze, silver, gold or platinum plan. All plans are HMOs and vary from state to state. 

All Molina healthcare plans include preventative care services as mandated by the federal government. Health plans also include family planning services, pediatric vision, pediatric dental, home healthcare services and formulary preventative prescription drugs without factoring in the deductible. 

Molina’s health plans cover mental health services for in-patient and out-patient care. Plans also cover rehabilitation and habilitation services, skilled nursing care, durable medical equipment and hospice. 

Patients must pay higher rates for out-of-network providers. Remember, health care companies delineate the types of health insurance you get based on network eligibility. Plus, medical services are covered in different ways depending on which plan you choose. Because all health benefits programs are different, this generation of health insurance requires a little more research on the consumer’s side.

Molina Insurance Customer Service

Compared to other healthcare providers, Molina’s customer service ratings could be higher. 

Individuals may reach the company by calling a member services representative between 7 a.m. and 7 p.m. Monday through Friday. Patients who need assistance with long-term services and support (LTSS) can call a special line for questions about long-term services such as nursing care. 

The National Association of Insurance Commissioners (NAIC) complaint index or the Better Business Bureau has not received complaints about Molina.

Consumers ranked Molina 2.8 out of 5 for customer service. For quality of care, Molina ranks 2.5. The Net Promoter Score (NPS) ranks companies for consumers’ willingness to refer the company to a friend. Consumers ranked Molina last on the NPS.

Claims are easy to submit with Molina, which prefers to receive claims within 90 days of the date of service. Molina also has a limit of 180 days for secondary claims. 

Molina processes over 90% of its claims within 30 calendar days. Nearly all claims are processed within 90 days after receipt of the claim, which means patients will know how much they must pay within a reasonable timeframe. 

BBB RatingA+
AM Best RatingNot rated
NAIC Complaint Index0 complaints
Moody’s RatingBa3 Stable
J.D. Power RatingNot applicable

Molina Insurance Pricing

You can get a quote for health insurance in a few minutes by going to Molina’s website. It is an easy way to assess health insurance costs. 

A 35-year-old non-smoking female who lives in Ohio can expect to pay about $210 per month for the Molina Constant Care Silver 7 250 HMO health plan. She may qualify for a subsidy to help pay for the premium, depending on her income. If, for example, the woman made $40,000 per year, she could get a subsidy of about $150 to pay for her healthcare premiums. 

With this plan, she would not have to pay a deductible before receiving services. If she went to her primary-care doctor, she would only pay $30 for the visit. If she needed a specialist, she could expect to pay $90 for the visit. Prescriptions would cost her up to $30 for generic drugs. If her medical bills maxed out her policy, her out-of-pocket responsibility would be $8,550.

On average, a woman of this age could expect to pay about $2,974 per year, which equates to $248 per month. 

The company offers seven plans in Ohio, and the Constant Care Silver 7 250 HMO ranks 25th of all plans available in the state.  

Molina Healthcare’s main competitors are Humana Inc., L.A. Care Health Plan, Dignity Health, Magellan Health and Centene Corp. Molina ranks second among these companies in the area of premium pricing. 

Molina Healthcare accepts checks, credit cards and electronic funds transfers (EFTs). Consumers can mail their payments into the company, phone in payments, pay online or pay in person. 

Maximum Annual out of Pocket$0
Minimum Deductible$0

California-based Molina offers the following plans in its home state:

1. Molina Minimum Coverage HMO:  $8,700 deductible and $8,700 out-of-pocket maximum. No cost for primary care or specialist visits. 

2. Molina $0 Cost Share HMO AI-AN: $0 deductible and $0 out-of-pocket maximum. No fees for primary care or specialist visits.

3. Molina Bronze 60 HMO: $6,300 deductible and $8,200 out-of-pocket maximum. Primary care office visits are $65, and specialist visits are $95.

4. Molina Silver 70 HMO: $3,700 deductible and $8,200 out-of-pocket maximum. Primary care office visits are $35, and specialist visits are $70.

5. Molina Silver 73 HMO: $3,700 deductible and $6,300 out-of-pocket maximum. Primary care office visits are $35, and specialist visits are $70.

6. Molina Silver 87 HMO: $800 deductible and $2,850 out-of-pocket maximum. Primary care office visits are $15, and specialist visits are $25. 

7. Molina Silver 94 HMO: $75 deductible and $800 out-of-pocket maximum. Primary care office visits are $5 and specialist visits are $8. 

8. Molina Gold 80 HMO: $0 deductible and $8,200 out-of-pocket maximum. Primary care office visits are $35, and specialist visits are $65.

9. Molina Platinum 90 HMO: $0 deductible and $4,500 out-of-pocket maximum. Primary care office visits are $15, and specialist visits are $30.

The Molina Cost Share HMO AI-AN is specifically designed for American Indians and Alaskan Natives who have household incomes between 100% and 300% of the federal poverty level. 

Overall, the benefits of Molina health plans are similar to its competitors, although its pricing is typically more favorable than its competitors.   

Molina Insurance Application Experience

It is easy to apply for a Molina healthcare plan by going to its website. It will ask the same basic questions as any other health plan provider, including gender, age, marital status, smoking status and income. Applicants will be asked to share their email addresses to receive quotes, which also will available online when they’re ready. 

Quotes will detail whether the consumer qualifies for a subsidy and how much the subsidy will contribute to their premium payments.

Molina also has a handy mobile app that popular with consumers. Users can easily view their policies on their mobile phones. They can also share their Molina member ID card or get a replacement card. 

Consumers who need assistance can use the mobile app to contact the 24-hour Nurse Advice Line or get in contact with their care manager. People who prefer using a desktop or laptop computer can get the same features directly on Molina’s website.

Molina customers also enjoy access to the My Molina portal. They can use the portal to make payments, change doctors, update their contact information or request an ID card. They can also log in to view their service history or get health reminders on necessary services.

For people who need language assistance, Molina also offers multi-language interpreter services. 

My Molina is a one-stop platform where consumers can manage almost all aspects of their healthcare needs. 

Molina Healthcare vs Competitors

Compared to its competitors, Molina is the leader in providing affordable care. The company has a heart for low-income people who need healthcare and have trouble affording it. Molina’s health plans reflect the company’s care and concern for underserved populations and people who fail to seek healthcare because of the costs. 

Molina also offers catastrophic health plans and high-deductible plans to people who otherwise might not be able to afford coverage. 

Another area where Molina Healthcare shines is in wellness and preventative services. Many wellness services are free. Most importantly, Molina treats all people regardless of race, ethnicity or gender with dignity and compassion. 

While Molina Healthcare only offers HMO health plans in most states, because of the variety of options, there is something suitable for everyone.

Molina Health Insurance Overall

Molina Healthcare gets an overall rating of 3 out of 5 stars. 

Consumers find the website easy to use for getting quotes on multiple health plans. The patient portal is convenient for looking up covered services, coverages and deductibles, bills, payments and personal health information. Molina’s mobile app keeps consumers informed while they are on the go. 

The variety of plans is excellent with multiple options for low or high deductibles and out-of-pocket costs. 

Molina also gets high scores for promoting wellness activities and providing preventative services at no cost. 

Consumers can expect to get their claims resolved in a timely manner and receive an explanation of benefits and charges.

The only thing Molina could improve on is to provide better customer service and bring their ratings for serving customers up higher, but overall, they are a good choice of a healthcare provider.  

Frequently Asked Questions

Q

Does Molina offer vision or dental care?

A

Molina offers supplemental policies for vision and dental care. Consumers can choose preventative or comprehensive plans. This is part of Molina’s commitment to wellness.

Q

Do consumers qualify for a subsidy to help pay for healthcare premiums?

A

Many consumers qualify for subsidies to offset the cost of the premium. The subsidy is determined by the individual’s income and the answers to questions on the application. Applicants will learn whether they qualify for a subsidy and how much it is at the time they receive their quote.

Sources

  1. HealthCare.gov. “Preventative Health Services.” Accessed March 3, 2022.
  2. NAIC Complaint Index. Accessed March 3, 2022.
  3. Better Business Bureau. Accessed March 3, 2022.   

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About Maurice Draine

Maurice Draine is a former insurance agent, broker, underwriter tech, and agent sales support rep with over 15 years of professional writing experience. Maurice helps insurance, financial, and various online and ad agencies, create the words that drive customers to their websites and keeps them there.