Molina Healthcare has over 1.3 million members in eight states. In 1980, a Dr. C. David Molina opened a community clinic where he cared for patients who were on a tight budget.  Today, David Molina's family lead Molina Healthcare and introduced Medicare services in 2006. There are different plans that Molina Healthcare offers depending on the state you live in.

 

Molina Medicare Options Plus HMO

This is a Drug Special Needs Plan for those who have Medicare and full Medicaid. There is a $0 monthly plan premium based on the beneficiary's level of Medi-Cal eligibility.  Referral is required for network specialists and members must go to in-network doctors, specialists and hospitals.  The plan covers 90 days each benefit period and there is a $0 yearly deductible and $0 copay for inpatient hospital care, inpatient mental health care and skilled nursing facility as well as doctor office visits and some other specialist services. The Options Plus HMO is currently available in California, Florida, Michigan, Ohio, Texas, Utah, and Washington.

 

Molina Medicare Options HMO

This is a Medicare Advantage Prescription Drug plan for those who have Medicare.  Those who are entitled to Medicare Options are entitled to Medicare Part A and who are enrolled in Medicare Part B.  There is a $45 monthly plan premium in addition to your monthly Medicare Part B premium and members must see in-network doctors, specialists, and hospitals.  Referral is also required for network specialists.  A $300 co-pay for each Medicare-covered impatient hospital stay is required and covers 90 days for each benefit period.  A $500 co-pay for each Medicare-covered impatient mental health care stay is required and covers 190 in a Psychiatric Hospital for one lifetime.  For Skilled Nursing Facilities, days 1-10 require a $0 co-pay while days 11-100 require a $50 copay.  For in-network doctor's visits a $10 co-pay for each primary care, a $25 for urgent care and a $15 for each specialist visit are required from members. If you live in California, Florida, Michigan, New Mexico, Ohio, Texas, Utah, or Washington, you may qualify for Medicare Options HMO.

 

Molina Medicare Healthy Advantage HMO

This is a Medicare Advantage Prescription Drug Special needs Plan for those who have Medicare and full Medicaid.  Those who are entitled to Medicare Options Plus are entitled to Medicare Part A and full Medicaid and is enrolled Medicare Part B.  Healthy Advantage covers Medicare Part B and Medicare Part D prescription drugs.  There is a $0 monthly plan premium based on the beneficiary's level of Medi-Cal eligibility.  Referral is required for network specialists and members must go to in-network doctors, specialists and hospitals. The plan covers 90 days each benefit period and there is a $0 yearly deductible and $0 co-pay for inpatient hospital care, inpatient mental health care and skilled nursing facility as well as doctor office visits and some other specialist services.  Skilled Nursing Facilities are covered up to 100 days for each benefit period, Inpatient Mental Health Care is covered up to 190 in a Psychiatric Hospital in a lifetime, and 90 days are covered for Inpatient Hospital care. The Health Advantage HMO is offered to citizens of California, Michigan, and Utah.

 

Molina Medicare SmartSaver HMO

This is a Medicare Advantage Prescription Drug plan for those who have Medicare.  Those who have Medicare Part A and who are enrolled in Medicare Part B are entitled to Medicare SmartSaver.  There is a $0 monthly plan premium in addition to a member's monthly Medicare Part B premium.  Referral is required for network specialists and members must go to in-network doctors, specialists and hospitals.  The plan covers 90 days each benefit period and there is a $0 yearly deductible and $0 co-pay for inpatient hospital care, inpatient mental health care and skilled nursing facility as well as doctor office visits and some other specialist services.  Skilled Nursing Facilities are covered up to 100 days for each benefit period, Inpatient Mental Health Care is covered up to 190 in a Psychiatric Hospital in a lifetime, and 90 days are covered for Inpatient Hospital care. The Molina SmartSaver HMO plan is currently only available in Florida.

 

Molina Plan 1 & 2 HMO

These are Employer Retirement plans and Medicare Advantage Prescription Drug plans for those who have Medicare.  Those who are eligible for Molina Plan 1 & 2 are entitled to Medicare Part A and are enrolled in Medicare Part B.  There is a $98 monthly plan premium for Molina Plan 1 and a $42 monthly plan premium for Molina Plan 2 in addition to the Medicare Part B premium.  Referral is required for network specialists and members must go to in-network doctors, specialists and hospitals.  For both plans, a $5 primary care and $25 specialist deductible per doctor visit and a $250 per hospital visit is required.  For a Skilled Nursing Facility, both plans require a $0 co-pay for Days 1-20 and a $125 co-pay for Days 21-100. You can enroll in either of these plans if you live in New Mexico.

 

ChoicePartners Medicare HMO

If you have Medicare and want a prescription drug plan, you may want to look into this plan.  If you qualify for ChoicePartners Medicare, you must also be eligible for Medicare Part A and already receiving Part B benefits. There is a $50 monthly plan premium in addition to monthly Medicare Part B premium.  Referral is required for network specialists and members must go to in-network doctors, specialists and hospitals.  For inpatient hospital stays, Days 1-5 require a $200 co-pay and Days 6-90 require a $0 co-pay.  For inpatient mental health care, Days 1-5 require a $250 copay and Days 6-90 require a $0 co-pay.  For a Skilled Nursing Facility, both plans require a $0 co-pay for Days 1-10 and a $150 co-pay for Days 11-100.To enroll in the ChoicePartners HMO, you must be a resident of Washington state.