Molina Healthcare Review & Complaints: Health, Medicare & Medicaid Insurance (2024)

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California-based Molina Healthcare is an HMO offering a range of plans across several states. They not only offer health insurance but also run medical clinics as well as offering managed care. But is Molina healthcare good? How are Molina reviews? We will answer those questions in our review of Molina Healthcare.

If you are interested in learning more, then read our Molina Healthcare Insurance health insurance review below. Being informed will help you find affordable Molina Healthcare Insurance health insurance for your status. Be sure to also compare rates from top insurance companies by entering your ZIP code into our free comparison tool above.

What is Molina Healthcare?

Molina’s namesake, C. David Molina, worked as an emergency room physician in Long Beach, CA when he started his own medical clinic to help low-income patients receive access to care regardless of their ability to pay. Founded in 1980, Molina grew over the years, and in 1997 expanded through acquisition into Utah and Michigan. Continued expansion brought the company into several other states. The company went public in 2003.

Molina health care services offers Marketplace affordable health insurance plans, Molina Medicare, and Medicaid options across most of its service areas, although not all plans are offered in all states. Molina today is a Fortune 500 company and covers more than 3.5 million people. In keeping with their founder’s goal of helping low-income patients, many of the plans offered are in conjunction with state-sponsored or federal programs.

Molina also participates in the marketplace, offering individual and family plans at all levels.

What Molina health plans are available?

Medi-Cal

Molina partners with the state of California to offer Medi-Cal coverage to low-income families. This plan is only available to those who qualify under state regulations.

The Medi-Cal plan covers a wide variety of healthcare needs including all preventative care, maternity care, hospital treatment, and even vision. Some coverage varies by county.

Medicare and Medicaid

Molina offers their Medicare Options Plan to Medicare-eligible members and the Plus plan for special needs patients who are eligible for both Medicare and Medicaid. Both plans are HMO-SNP plans that include prescription drugs.

These plans cover all medical care in addition to prescriptions, but hearing, dental, and vision are offered as Medicare supplement insurance coverage. As an HMO, in-network providers must handle all coverage, although out-of-network care may be authorized when required.

The Molina Dual Options Cal MediConnect plan is a specialized plan for those who qualify for both Medicare and Medicaid.

What marketplace plans are available?

Molina’s Covered California plans are marketplace health plans offering coverage within the HMO network. All these coverage plans come with deductibles, which is why understanding health insurance deductibles is important. We’ve provided some examples of Molina’s Silver Plan deductibles in the chart below.

The Minimum Coverage plan is a catastrophic plan that not all members will qualify for due to certain restrictions. This plan has a $7,150 individual and $14,300 family combined deductible for medical, prescriptions, and pediatric dental. All care is paid out of pocket until the deductible is met, at which point coverage kicks in at 100%.

There is one Bronze plan available, the Bronze 60, which has a $6,300 individual deductible and $12,600 family deductible. The prescription deductible is separate with $500 for individual and $1,000 for family, and prescriptions are covered at 100% after this deductible, up to $500 per prescription. Copays are $75 across the board for regular office visits and services.

Molina insurance has four Silver healthcare services plans:

Molina Silver 94 HMO has very low deductibles, at $75/$150 individual and family. Copays are very low at $5 for a primary care visit and $8 for a specialist visit. Prescriptions start at $3 for Tier 1 drugs. This is likely the most expensive of the Silver options.

Silver 87 has copays of $10 for primary care and $25 for specialists. The deductibles are $650 individual and $1,300 family. Prescriptions start at $5 for Tier 1 drugs.

Silver 73 has a $2,200 individual deductible and a $4,400 family deductible. Copays are $30 for primary care and $55 for specialist visits. Prescriptions start at $15 for Tier 1 drugs.

The Silver 70 plan has a $2,500 individual deductible and a $5,000 family deductible. Copays are $35 for primary and $70 for specialist visits. Like the previous plan, Tier 1 drugs are $15 with prices varying from there.

The Gold plan is the Molina Gold 80. This is a zero deductible plan with copays that match the Silver 73 plan at $30 and $55. Prescription drugs also have no deductible and start at $15.

The Platinum Plan is also a zero deductible plan. Primary care is covered with a $15 copay and specialist visits have a $40 co-pay. Like the Gold plan, there is no prescription deductible, and drugs start at $5. There don’t seem to be any Molina Marketplace Silver Plan reviews available online.

When asking if Molina Insurance is good you will also want to consider how affordable the healthcare services coverage rates are, which we discuss below.

Are Molina Healthcare rates affordable?

Molina Healthcare Insurance health insurance quotes aren’t available online for their Medicare or Medi-Cal insurance products, however, there is a form that can be filled out in order to request information and Molina Healthcare Insurance health insurance rates. Quick quotes are available for marketplace plans.

We ran a quote in California for a single 30-year-old with an income of $50,000. The Bronze plan returned a rate of $173.18 per month and $227.49 for the Silver 70 plan. The Gold 80 plan came in at $255.00 and the Platinum Plan at $294.67. As our sample person qualifies for the catastrophic plan, we did return a quote of $173.14 for that option. However, when you go to buy Molina Healthcare Insurance health coverage, you might find a much different rate.

These rates appear to be reasonable, however, because health insurance plans have costs that can vary based on the person it is difficult to compare them even with a quote. The variety of options makes it increasingly difficult to create apples-to-apples comparisons across and even within companies. It’s important to compare each company you shop with to the average health insurance cost per month in the U.S.

Is the Molina Healthcare claims process simple?

Ease of Filing a Claim (Online, Over the Phone, Mobile Apps)

As a healthcare company, the company handles all health care claims directly and internally. Since they are an HMO, their billing departments will be connected to the providers directly, so there should rarely be an instance in which a member needs to handle a claim. Be sure to check online for Molina Healthcare provider reviews specifically.

Molina Healthcare offers multiple channels for filing claims, providing flexibility and convenience to policyholders. You can file a claim through their online portal, over the phone, or via their mobile app. This variety of options ensures that policyholders can choose the method that best suits their preferences and needs.

Average Claim Processing Time

The average claim processing time with Molina Healthcare can vary depending on the specific nature of the claim and its complexity. Policyholders should expect reasonable processing times, but it’s advisable to check with the company for more precise information regarding the processing times for different types of claims.

Customer Feedback on Claim Resolutions and Payouts

Customer feedback on claim resolutions and payouts with Molina Healthcare is mixed. While some policyholders report smooth and satisfactory claim experiences, others have expressed concerns about delayed payouts and claim denials.

It’s essential for prospective policyholders to review customer feedback and consider their specific needs and circumstances when evaluating Molina Healthcare’s claim resolution process.

Molina Healthcare Digital and Technological Features

Mobile App Features and Functionality

Molina Healthcare offers a mobile app that allows policyholders to manage their insurance on the go. The app provides features such as access to policy information, claims filing, appointment scheduling, and more. It offers a user-friendly interface and convenience for policyholders who prefer managing their insurance digitally.

Online Account Management Capabilities

Policyholders can efficiently manage their accounts online through Molina Healthcare’s website. This includes tasks like updating personal information, reviewing policy details, and accessing important documents. The online account management system enhances convenience and accessibility for policyholders.

Digital Tools and Resources

Molina Healthcare provides various digital tools and resources to assist policyholders in understanding their coverage and making informed decisions. These resources may include educational materials, cost calculators, and healthcare provider directories, all accessible online.

These digital tools aim to empower policyholders with valuable information about their insurance options and healthcare choices.

Are reviews of Molina Healthcare positive?

Molina Healthcare: What’s the bottom line?

So is Molina health insurance good? Molina Healthcare Insurance is a big health insurance company but seems to have somewhat moved away from its founder’s goal of putting patients before dollars. They have a good selection of plans at reasonable rates and may be helpful to those looking for help with state-run programs.

Their reputation, however, is tarnished by a large number of Molina Healthcare, Inc. reviews that feature similar complaints and failure to respond to and resolve problems. Molina Healthcare plan reviews aren’t the best. The same goes for Molina Healthcare reviews in Texas as well as many other states. Additionally, Molina offers a mobile app for both iOS and Android.

Despite negative Molina Marketplace Insurance reviews, Molina Healthcare Insurance might be a good option for some. Compare insurance rates from other top companies, by using our comparison tool below.