Most confusion about Molina comes from the fact that two completely different products carry the same name. One is a Medicaid plan the state assigns you and you mostly do not pay for. The other is an ACA Marketplace plan you shop for and pay a premium on. Same insurer, same card design, completely different economics.
This page separates them, using Molina’s own SEC filings for the membership and revenue numbers and CMS’s 2026 Marketplace rate and plan files for the premiums, deductibles and quality ratings. Those CMS files were last imported to CMS systems by August 4, 2026.
What Is Molina Healthcare
Molina Healthcare, Inc. (NYSE: MOH) is a Long Beach, California company that has been in government-sponsored health coverage since 1980. Its 2025 Form 10-K describes four reportable segments: Medicaid, Medicare, Marketplace and Other, and says it “served approximately 5.5 million members as of December 31, 2025, located across 21 states.”
Medicaid is the business. The 10-K states that “Medicaid premium revenue constituted 75% of our consolidated premium revenue in the year ended December 31, 2025,” with the four largest health plans in California, New York, Texas and Washington.
Here is the split as of June 30, 2026, from Molina’s second-quarter results released July 22, 2026:
| Molina segment | Members, June 30, 2026 | Members, June 30, 2025 | Q2 2026 premium revenue |
|---|---|---|---|
| Medicaid | 4,418,000 | 4,774,000 | $8,049 million |
| Medicare | 224,000 | 267,000 | $1,565 million |
| Marketplace | 283,000 | 690,000 | $628 million |
| Other | 1,000 | 15,000 | $2 million |
| Total | 4,926,000 | 5,746,000 | $10,244 million |
Marketplace lost 59% of its members in a year. Molina’s own 10-K predicted it: “The expiration of subsidies in Marketplace in 2025 will lead to a reduction in membership and result in an adverse acuity shift in the overall market risk pool.” Our ACA subsidy expiration guide explains what lapsed and what did not.
How Molina Medicaid Works
This is the part most people are actually asking about. When a state contracts out its Medicaid program, it pays private managed care organizations a fixed monthly amount per enrollee to run the coverage. Molina is one of those organizations. CMS publishes the enrollment data in its Medicaid Managed Care Enrollment Report, where the most recent complete data is for 2024.
The practical consequences for you:
You do not choose Molina the way you choose a Marketplace plan. You qualify for Medicaid through your state, then pick from the managed care plans your state offers, or get assigned to one. See Medicaid income limits for 2026 for eligibility and what Medicaid covers for benefits.
Your out-of-pocket cost is set by state and federal Medicaid rules, not by Molina. Copays where they exist are nominal. There is no premium in most cases. How much Medicaid costs covers the exceptions.
Molina’s Medicaid business is under pressure. Its 10-K estimates the One Big Beautiful Bill Act will drive “a 15% to 20% reduction” by 2029 on the 1.2 million members in its Medicaid Expansion population. If you are in expansion Medicaid, watch your renewal notices.
If you are not sure which program you are in, Medicaid vs Medicare sorts it out.
What Molina Marketplace Plans Cost in 2026
Now the part you pay for. Every figure below is the 2026 plan year, for a 40-year-old non-smoker, before any premium tax credit, from 1,236 age-40 rate rows across Molina’s 78 on-exchange individual plans in the six states where it sells through HealthCare.gov.
| 2026 Molina Marketplace figure | Low | Median | High |
|---|---|---|---|
| Monthly premium, age 40, all tiers | $428 | $616 | $1,100 |
| Monthly premium, expanded bronze | $428 | $581 | $867 |
| Monthly premium, silver | $489 | $601 | $992 |
| Monthly premium, gold | $507 | $635 | $1,100 |
| Individual deductible, standard on-exchange plans | $0 | $3,500 | $7,500 |
| Individual out-of-pocket maximum | $8,000 | $8,945 | $10,350 |
| Silver deductible (standard variant) | $5,750 | $6,000 | $7,000 |
| Gold deductible | $750 | $1,640 | $2,250 |
Across all 4,044 individual plans in the same CMS file, the national median age-40 premium is $691.56, ranging from $277.59 to $3,051.03. Molina’s median of $616.18 is below the national median, but its floor of $427.71 is the highest floor of the three big Marketplace-focused carriers. Molina has no cheap entry point: Oscar’s cheapest plan is $300 and Ambetter’s is $357.
Two structural notes.
Molina’s plan lineup is narrow and uniform. All 78 on-exchange plans are HMOs, none require a specialist referral, and 15 are HSA-eligible. There is no PPO option and no catastrophic plan. If out-of-network coverage matters to you, see HMO vs PPO and in-network vs out-of-network, because a Molina HMO generally pays nothing outside the network except in emergencies.
Silver looks worse than it is for lower incomes. The silver deductibles above are standard variants. Below roughly 250% of the federal poverty level, cost-sharing reductions rewrite those numbers downward, and they only attach to silver plans. Above that line, Molina’s gold plans carry a median deductible of $1,640 against $6,000 on silver for about $34 a month more, which is often the better deal.
For context on what enrollees actually pay, KFF found the average net Marketplace premium rose 58% from $113 to $178 a month between 2025 and 2026, while average Marketplace deductibles rose 37% to a record high of $3,786.
Is Molina a Good Insurance?
CMS rates Marketplace plans 1 to 5 stars through its Quality Rating System, the exchange counterpart of Medicare Advantage star ratings. It is the only independent quality measure attached to these plans, and it is not flattering here.
In the plan year 2026 nationwide file, Molina has six rated products (a product is one issuer in one state with one plan type, not one plan). Three are at 2 stars and three at 3 stars, for an average of about 2.5. There is no 4-star or 5-star Molina product anywhere in the file. The national average across 298 rated products is about 3.4, and nationally 143 products earn 4 or 5 stars.
So on measured quality, Molina is the weakest of the three carriers in this comparison, with a hard ceiling of 3 stars. That is a real finding and it should weigh on your decision if a better-rated plan is available in your county. KFF’s participation data shows that is not always the case: 165 counties had only one Marketplace insurer in 2026, up from 93 in 2025, and one in three counties has fewer insurers than a year earlier.
Who Molina Is Good For and Who Should Skip It
A good fit if you are on Medicaid and Molina is offered in your state. The quality-rating critique above applies to Molina’s Marketplace products. Your Medicaid options are whatever your state contracts, and Molina is a long-established operator in that space.
A good fit if you are moving between Medicaid and the Marketplace. Molina runs both, so if your income rises past the Medicaid line, staying with the same insurer can mean keeping some of the same doctors. Check the network, not the logo.
A good fit if you want gold coverage at a modest premium. Molina’s median gold deductible of $1,640 is the lowest of the three carriers here.
Think twice if you want the cheapest possible premium. Molina’s $428 floor is the highest floor of the three.
Think twice if you need a PPO or out-of-network coverage. Molina sells HMOs only on the exchange.
Think twice if quality ratings drive your choice. At about 2.5 stars with no product above 3, Molina is where the ratings point away from.
Molina vs. Ambetter vs. Oscar
| 2026 plan year | Molina | Ambetter | Oscar |
|---|---|---|---|
| Marketplace states | 14 | 29 | 20 |
| Median age-40 premium, federal platform | $616 | $659 | $606 |
| Premium floor | $428 | $357 | $300 |
| Plan types on exchange | HMO only | HMO, EPO, PPO, POS | HMO, EPO, a few PPO |
| Median gold deductible | $1,640 | $1,450 | $2,000 |
| CMS quality rating, average | about 2.5 stars | about 3.0 stars | about 2.7 stars |
| Marketplace members, Q2 2025 to Q2 2026 | 690K to 283K | 5.86M to 3.49M | 2.03M to 2.96M |
| Also runs Medicaid plans | Yes, 4.4M members | Yes, through Centene | No |
The distinguishing feature is the Medicaid book. Molina is a Medicaid company that also sells on the exchange, and its Marketplace segment is now smaller than either competitor by an order of magnitude.
The Bottom Line
Ask which Molina you mean before asking what it costs. Medicaid Molina is a government program administered by a private company, and it costs you almost nothing. Marketplace Molina is a mid-priced HMO, roughly $430 to $1,100 a month at age 40 before subsidies in 2026, with a median near $616, a median gold deductible of $1,640, and CMS quality ratings that top out at 3 stars.
Three checks before you enroll in a Molina Marketplace plan. Compare gold against silver in your county, because the deductible gap is large and the premium gap is small. Confirm your doctors are in that specific HMO network, since there is no out-of-network fallback and an insurance denial appeal is a poor substitute. And look up the star rating for the exact product rather than the brand.
One timing note. All of the above is 2026 plan year data. HealthCare.gov lists Open Enrollment for 2027 coverage as starting November 1, 2026, with December 15 the deadline for January 1 coverage and January 15, 2027 the last day. If your income dropped and you are between jobs, check health insurance for the unemployed and when open enrollment runs before assuming you have to wait.