Molina Healthcare offers both Medicare and Medicaid plans, depending on which state you live in and which program you enroll in
Molina Healthcare is an insurance company that contracts with both Medicare and Medicaid to offer coverage. They are not Medicare or Medicaid themselves — they are a private company that administers health plans under those government programs. Which type of plan you get from Molina depends entirely on which program you sign up for and whether your state's Medicaid program uses them.
If you enroll in a Molina Medicare Advantage plan, you are getting a Medicare plan. If you enroll in a Molina Medicaid plan, you are getting a Medicaid plan. Some states offer both, some offer only one, and some do not use Molina at all. Your state of residence determines what Molina offers in your area.
Key Takeaways
- Molina Healthcare administers both Medicare Advantage plans and Medicaid managed care plans, but which one is available to you depends on your state.
- Medicare Advantage plans through Molina are for people age 65 and older or those with certain disabilities who are already on Medicare.
- Medicaid plans through Molina are for people with lower incomes who meet your state's Medicaid rules.
- You can check whether Molina offers plans in your state by visiting their website or calling 1-888-665-4621 to speak with someone about your options.
- The plans available, the costs, and the coverage differ significantly between Medicare and Medicaid, so understanding which program you are in matters for your out-of-pocket costs and covered services.
How Molina works with Medicare
Molina Healthcare offers Medicare Advantage plans in many states. These are also called Part C plans. If you are already enrolled in Original Medicare (Part A and Part B), you can choose to switch to a Molina Medicare Advantage plan during the annual enrollment period, which runs from October 15 to December 7 each year.
A Molina Medicare Advantage plan bundles your hospital coverage (Part A), doctor coverage (Part B), and usually prescription drug coverage (Part D) into one plan. You pay a monthly premium to Molina instead of to Medicare directly. Molina then receives a payment from Medicare to cover your care. The out-of-pocket costs — copays, coinsurance, and deductibles — vary by plan and by state.
Not every state has Molina Medicare Advantage plans available. Molina operates in some states but not others, and the specific plans they offer change year to year. You can see which plans Molina offers in your state by visiting Medicare.gov and using their plan finder tool, or by calling Molina directly at 1-888-665-4621.
How Molina works with Medicaid
Molina Healthcare also administers Medicaid managed care plans in many states. Medicaid is a joint federal and state program for people with lower incomes. Each state runs its own Medicaid program and decides which insurance companies can offer plans in that state.
If you are enrolled in your state's Medicaid program and your state uses Molina, you may be assigned to a Molina Medicaid plan or you may be able to choose Molina from a list of available plans. Medicaid coverage and costs vary widely by state — some states cover more services, some charge small copays, and some charge nothing at all. Molina administers the plan your state has set up, but Molina does not set the rules or the coverage.
To find out whether Molina offers Medicaid plans in your state, contact your state's Medicaid office directly. You can also call 2-1-1 (a free referral line) and ask about Medicaid managed care plans in your area, and they can tell you which companies operate there.
The key differences between Molina Medicare and Molina Medicaid
Even though both are Molina plans, Medicare Advantage and Medicaid managed care are very different programs with different rules, costs, and coverage.
| Feature | Molina Medicare Advantage | Molina Medicaid |
|---|---|---|
| Who it is for | People age 65 and older, or people under 65 with certain disabilities, already on Medicare | People with lower incomes who meet your state's income and resource limits |
| Who pays for it | You pay a monthly premium; Medicare pays Molina | Your state and the federal government pay Molina; you may pay little or nothing |
| Enrollment period | October 15 to December 7 each year (Annual Enrollment Period) | Year-round in most states; some states have open enrollment periods |
| Out-of-pocket costs | Copays, coinsurance, and deductibles vary by plan | Varies by state; many states have no copays or very small ones |
| Prescription drug coverage | Usually included in the plan | Covered by Medicaid; Molina administers it |
How to find out which Molina plans are in your state
The easiest way to see what Molina offers where you live is to use Medicare.gov if you are looking for Medicare plans. Go to Medicare.gov, click "Find Care Providers and Suppliers," then use the plan finder. Enter your zip code and it will show you all available plans in your area, including Molina plans if they operate there.
For Medicaid, contact your state's Medicaid office directly. You can find your state Medicaid office by calling 2-1-1 or by visiting Medicaid.gov and selecting your state. They can tell you whether Molina administers Medicaid plans in your area and how to enroll.
You can also call Molina directly at 1-888-665-4621. They can tell you which Medicare and Medicaid plans they offer in your state and answer questions about coverage, costs, and how to enroll.
What happens if Molina is not available in your state
If Molina does not offer plans in your state, you have other options. For Medicare, dozens of other insurance companies offer Medicare Advantage plans in every state. For Medicaid, your state contracts with other managed care companies to administer plans. In either case, you can compare plans available to you and choose the one that best fits your needs and budget.
The process for comparing and choosing a plan is the same whether you choose Molina or another company. For Medicare, use Medicare.gov's plan finder. For Medicaid, contact your state Medicaid office or call 2-1-1 to learn what plans are available and how to enroll.
Frequently Asked Questions
Can I have both a Molina Medicare plan and a Molina Medicaid plan at the same time?
Yes, if you are may be able to access for both Medicare and Medicaid (sometimes called "dual may be able to access"), you can enroll in both a Molina Medicare Advantage plan and a Molina Medicaid plan. Some people may have access to for both programs. Your state Medicaid office and Medicare can tell you whether you are dual may be able to access and help you understand how the two plans work together.
Does Molina charge a monthly premium for Medicaid plans?
No. Medicaid is funded by your state and the federal government, not by premiums from members. You do not pay a monthly premium for a Molina Medicaid plan. You may have small copays for some services depending on your state's rules, but most Medicaid plans have no copays or very low ones.
Can I switch from a Molina Medicare plan to a different company's plan?
Yes. You can change plans during the Annual Enrollment Period (October 15 to December 7) each year. You can also switch plans during the Medicare Advantage Open Enrollment Period (January 1 to March 31) if you are already in a Medicare Advantage plan. Contact Medicare or visit Medicare.gov to make a change.
What if I have a problem with my Molina plan?
Contact Molina directly at 1-888-665-4621. If you are not satisfied with their response, you can file a complaint with Medicare (for Medicare plans) or your state Medicaid office (for Medicaid plans). Both have formal processes for handling member complaints.
How do I know if Molina is in-network for my doctor?
Call Molina at 1-888-665-4621 or visit their website and use their provider search tool. Enter your doctor's name and they will tell you whether that doctor is in the Molina network in your area. You can also ask your doctor's office directly whether they accept Molina plans.