Medicare Advantage

Comparing Molina Medicare Advantage Options For 2019

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Molina Healthcare serves as an administrator of government-run healthcare programs, including Medicare Advantage. The company began providing medical services in 1980 and became licensed to operate an insurance plan in 1994.

2019 Molina Medicare State Footprint

Molina’s Medicare plans are available in nine states in 2019: California, Florida, Michigan, New Mexico, Ohio, Texas, Utah, Washington and Wisconsin. Many of Molina’s products are joint Medicare-Medicaid plans that allow qualifying individuals to receive the benefits of both programs through one health plan.

In addition to Medicare programs, Molina administers Medicaid programs in some areas of the country and provides individual and family health insurance plans through marketplace exchanges. Altogether, the company operates in 15 states and territories. Almost 5 million people receive their health insurance through one of Molina’s programs.

Molina’s Medicare Advantage plans are HMOs with set networks of providers that members can use for their care. Many of the plans are classified as HMO-SNP, which means that membership is restricted to set populations of people, such as those who qualify for both Medicare and Medicaid.

With 44,000 enrollees in 2017, approximately 1 percent of Molina’s business was dedicated to standalone Medicare programs. Another 1 percent focused on Medicare-Medicaid programs, which served 57,000 members.

Molina Medicare Advantage Star Ratings

For each state in which Molina runs Medicare Advantage programs, CMS issues a star rating based on an evaluation of the available plans. For instance, Molina Healthcare of California received an overall score of 3.5 stars out of 5.0 for its 2019 plans. Molina Healthcare of Washington received the same score for its 2019 plans.

The National Committee for Quality Assurance (NCQA) also evaluates each state program individually and provides ratings for its Medicaid and marketplace plans. As an example, Molina Healthcare of New Mexico is accredited by NCQA, and its Medicaid program has achieved “Commendable” status.

2019 Molina Medicare Advantage Plans

Molina’s business largely centers on Medicare-Medicaid programs rather than the typical private options offered by other Medicare Advantage insurers. In 2019, Molina Medicare Advantage plans in every state except for Ohio will be DSNP, which are Medicare-Medicaid special needs plans. These plans will not be available in Ohio.

Below we’ve outlined two example plans from Molina so that you can see how they compare. Note that these plans are offered in different states (Idaho and Utah). These plans were available at the time of publishing, but they may change in 2019 since Molina is focusing on special needs plans for Medicare-Medicaid.

Molina Medicare Advantage 2019
Molina Medicare Options HMO (Idaho) Healthy Advantage Plus HMO (Utah)
Monthly premium $10 $0
Copay (primary) $5 $0
Deductibles $0 for medical $150 for drug (tiers 3-5) $0 for medical $0 for drug
Network In-network coverage only In-network coverage only
Rx coverage? Yes Yes
Rx cost $3 copay for tier 1 $2 copay for tier 1
Special features Hearing aids, preventive dental, $200 for eyewear every 2 years; transportation, credit for over-the-counter items every 3 months; chiropractic, health education, nutritional counseling and gym membership Preventive and comprehensive dental, $200 for eyewear every 2 years; credit for over-the-counter items every 3 months; chiropractic, health education, nutritional counseling, gym membership and remote access technologies
Out-of-pocket max $6,700 $5,400
CMS Star Rating 3.5 3.5

To check if you qualify for a Molina Medicare plan and for accurate pricing information, make sure you get a personalized quote based on where you live. Medicare plans – from any company, not just Molina – depend largely on where you live and your personal information, like age and gender and sometimes health status.

Not sure where to start the process on Medicare Advantage or Medicare supplement plans? We can help. Contact us today for a quote to learn more about your options for Medicare with Molina, or any other company, in 2019.

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