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Molina Medicare Advantage Plans 2027

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) | Last updated October 8, 2026

For 2027, Molina offers only Special Needs Plans in Medicare Advantage, so Molina plans are generally open only to people who qualify, such as those with both Medicare and Medicaid.

Molina Healthcare is best known for Medicaid and dual-eligible coverage. If you were in a Molina plan that is not a Special Needs Plan, check your mail for a non-renewal letter and compare other plans in your county.

See Molina Medicare plans and Medicare Advantage plans 2027.

✔ Licensed across all 50 states
✔ Built on CMS 2027 data
✔ No-cost plan comparison

Key Highlights

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Molina: Special Needs Plans only for 2027.

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Most Molina members have Medicare and Medicaid.

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Non-SNP members need a new plan.

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Nationally, the average 2027 Medicare Advantage premium is $12 a month, down from $14.37 (CMS).

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The Annual Enrollment Period is October 15 to December 7, 2026.

Compare plans and enroll online

Molina Special Needs Plans

Special Needs Plan Type Who Can Join What to Check
Dual Special Needs Plan (D-SNP) People with both Medicare and Medicaid How Medicaid and Medicare benefits are coordinated
Chronic Condition SNP (C-SNP) People with certain chronic conditions Which conditions qualify and which specialists are in network
Institutional SNP (I-SNP) People who live in or need a nursing facility level of care Which facilities the plan works with

Special Needs Plans include drug coverage and are designed around the needs of the people they serve. Availability varies by state and county, so confirm Molina offers a plan you qualify for in your ZIP code.

Benefits Molina Plans May Offer

Molina Plans May Include

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Hospital and medical coverage matching Original Medicare Part A and B

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Part D prescription drug coverage on most plans

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Routine dental, vision and hearing benefits

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Fitness programs and over-the-counter allowances

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Telehealth visits and care coordination programs

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A yearly out-of-pocket maximum on every plan

Benefits are not offered by every plan. They differ by plan and county and may change for 2027. Review the Evidence of Coverage for each plan before enrolling.

Understanding Molina Medicare Advantage Plans

What Changed at Molina for 2027

Watch for: if your Molina plan is not a Special Needs Plan, you should have received a non-renewal letter. Coverage continues through December 31, 2026.

Keep an eye out: a non-renewal letter will arrive if your plan is ending. You stay covered through December 31, 2026. Taking no action sends you back to Original Medicare with no drug coverage.

Guaranteed issue: when your Medicare Advantage plan exits your area, you can generally purchase certain Medicare Supplement plans with no health questions asked, up until 63 days after that coverage ends.

Find & Compare Plans Online

Speak with a licensed insurance agent

1-833-641-4938TTY 711

Mon-Fri: 8am-9pm ET

Other Insurers Going SNP-Only for 2027

Insurer 2027 Medicare Advantage Approach
Molina Special Needs Plans only
Horizon BCBS New Jersey Special Needs Plans only
Elderplan (MJHS, New York) Special Needs Plans only
Presbyterian Health Plan (New Mexico) Special Needs Plans only
Wellcare (Centene) in Nevada and Ohio Special Needs Plans only

If You Do Not Qualify for a Molina SNP

Another Medicare Advantage Plan

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Compare plans in your county

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Check doctors and drugs for 2027

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Enroll by December 7, 2026

Original Medicare + Medigap + Part D

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Any provider in the U.S. that accepts Medicare

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Generally a guaranteed issue right if your plan ends

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Add a Part D plan

2024 medicare advantage plans

Medicare, Medicaid and Extra Help

When your income and savings are limited, two programs can greatly lower your Medicare costs:

Medicare Savings Programs

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Run by your state Medicaid office

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May cover your Part B premium, and in some cases deductibles and coinsurance

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Income and asset limits vary by state

Extra Help (Part D)

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Run by Social Security

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Lowers Part D premiums, deductibles and copays

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Those enrolled in a Medicare Savings Program qualify automatically

If you qualify for both Medicare and full Medicaid, you may also be able to join a Dual Special Needs Plan. See help for low-income Part D beneficiaries.

How Medicare Advantage Works

Medicare Advantage, sometimes called Part C, lets you receive your Medicare benefits through a Medicare-approved private insurer. These plans cover everything Original Medicare Part A and Part B cover, with the exception of hospice care, which Original Medicare continues to pay for. Most also bundle Part D drug coverage, and many may tack on extras like routine dental, vision and hearing benefits.

The trade-off is that Molina plans typically rely on networks of doctors and hospitals and may ask for referrals or prior authorization before some services. Unlike Original Medicare, every Medicare Advantage plan caps what you pay out of pocket each year for covered medical care. Your Part B premium still applies, along with the plan’s own premium if it charges one.

Feature HMO PPO
Out-of-network care Not covered except emergencies and urgent care Covered at a higher cost
Referrals for specialists Usually required Usually not required
Premiums Usually lower Usually higher
Out-of-pocket maximum In-network limit In-network limit plus a higher combined limit
Best for Lower costs, local care Flexibility, travel, keeping specific doctors

Pros and Cons of Medicare Advantage

Advantages

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Often a low or $0 premium

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A yearly out-of-pocket maximum

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Drug coverage usually included

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Dental, vision and hearing benefits may be included in many plans

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One card and one plan

Tradeoffs

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Networks; except for emergencies, HMOs require in-network care

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Prior authorization and referrals are common

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Copays add up if you use a lot of care

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Plans and networks can change every year

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Moving to Medigap later may involve health questions

Molina Drug Coverage for 2027

Part D drug coverage is built into most Molina Medicare Advantage plans. Every plan sets its own formulary, drug tiers and pharmacy network, and costs are often lower at preferred pharmacies or by mail order. In 2027, a plan’s Part D deductible may be as high as $700, and out-of-pocket spending on covered drugs is capped at $2,400.

Tier Typical Drugs Typical Cost
Tier 1 Preferred generics Lowest copay
Tier 2 Generics Low copay
Tier 3 Preferred brand-name drugs Moderate copay
Tier 4 Non-preferred drugs Higher copay or coinsurance
Tier 5 Specialty drugs Highest coinsurance

Each plan sets its own tiers. Review every plan’s formulary.

A drug you take may not be on a plan’s 2027 formulary, or it may come with a rule such as prior authorization. Even then, you have options:

If Your Drug Is Not Covered

1

Request a transition fill. During the first 90 days of a new plan or plan year, plans generally have to provide a temporary supply of a drug you already take, giving you time to change drugs or ask for an exception.

2

Talk to your doctor about other options. A covered drug from the same class could work just as well for less money.

3

Ask for a tiering or formulary exception. Your doctor sends a statement explaining why you need the drug or a lower copay. Plans have to decide within set time limits.

4

Challenge a denial. When the plan turns you down, you have the right to appeal through several levels of review.

See steps to appeal a Medicare Part D denial.

If Your Plan Is Ending

Molina members whose plan is leaving their county for 2027 should have gotten a non-renewal notice in early October. You will not lose coverage immediately: it runs through December 31, 2026, which gives you time to decide.

If Your Plan Is Ending

1

Review your non-renewal letter. It verifies that your plan is ending and lays out your choices.

2

Write down your doctors and drugs. Comparing replacement plans requires them.

3

Compare your 2027 plan choices. Look at networks, drug coverage and the out-of-pocket maximum, not only the premium.

4

Pick a plan by December 31 to avoid a gap. If you enroll during Annual Enrollment by December 7, your coverage starts January 1, 2027.

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Rely on your Special Enrollment Period if necessary. If your plan is ending, you generally have until the end of February 2027 to make a choice.

If you take no action: on January 1, 2027, you go back to Original Medicare, and you will have no drug coverage unless you pick a Part D plan. Being without drug coverage may result in a late enrollment penalty.

Medigap rights: if your Medicare Advantage plan exits your area, you generally get a guaranteed issue right, lasting up to 63 days after your coverage ends, to purchase certain Medicare Supplement plans with no health questions.

How to Compare Molina Plans for 2027

How to Compare

1

Review your Annual Notice of Change. It spells out every 2027 change to the plan you have now.

2

Verify your doctors and hospitals. Make sure every provider is in the 2027 network, not only the 2026 network.

3

Review your prescriptions. Verify every drug, the tier it falls on and any step therapy or prior authorization rules.

4

Look at the full annual cost. Total up the premium, usual copays and drug costs, and review the out-of-pocket maximum.

5

Look at star ratings. Medicare scores plans on quality and service using a 1 to 5 star scale.

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Sign up by December 7. Coverage under your new plan begins January 1, 2027.

2027 Enrollment Dates

Enrollment Period Dates What You Can Do
Annual Enrollment Period October 15 to December 7, 2026 Join, change or drop a Medicare Advantage or Part D plan effective January 1, 2027
Medicare Advantage Open Enrollment January 1 to March 31, 2027 In Medicare Advantage, you can change to another plan or go back to Original Medicare one time
Initial Enrollment Period 7 months around your 65th birthday month Sign up for Medicare and choose your first plan
Special Enrollment Periods Varies Switch plans after events such as a move, a loss of other coverage or your plan exiting your area

Annual Enrollment is when most people make changes. If you like your current plan, no action is needed; it renews on its own. Even so, review your Annual Notice of Change, since networks, premiums, copays and drug lists can all change on January 1.

Star Ratings

Each fall, Medicare gives every Medicare Advantage and Part D plan a rating of 1 to 5 stars, based on factors such as preventive care, how well chronic conditions are managed, member complaints, customer service and accuracy of drug pricing. You can see the ratings in Medicare Plan Finder.

Using Star Ratings

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Ratings of 4 stars or more are generally a good indicator of quality and service

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A special enrollment period lets you move into a five-star plan once during the year

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A new plan may not have a rating yet, and that alone isn’t a bad sign

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Ratings reflect the plan as a whole, not how well it covers your particular doctors and drugs

Medicare Advantage or Medigap?

Medicare Advantage Original Medicare + Medigap
Monthly premium Often low or $0 (2027 average $12, CMS) Higher; varies by plan letter, age and ZIP
Doctors Usually a network Any provider in the U.S. that accepts Medicare
Costs when you get care Copays and coinsurance up to a yearly maximum Low and predictable; on Plan G, little or nothing once the Part B deductible is met
Drug coverage Usually included Add a separate Part D plan
Dental, vision, hearing Many plans may include some coverage Not included
Changing later Every year during Annual Enrollment Health questions in most states once your Medigap Open Enrollment Period ends

Help Paying Medicare Costs

When your income and savings are limited, two programs can greatly lower your Medicare costs:

Getting Help

You do not need to compare plans by yourself, and help should not cost you anything. Here are the free options:

Free Help Comparing Plans

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Available any time: Medicare Plan Finder on Medicare.gov

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1-800-MEDICARE (1-800-633-4227), reachable 24 hours a day on all seven days of the week

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Your State Health Insurance Assistance Program (SHIP), which provides free, unbiased counseling

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A licensed agent or insurance broker, who can compare plans across several insurers for free

Gather your Medicare card, a list of your drugs and doses, your doctors and your preferred pharmacies before you call. That way a long conversation becomes a quick one.

Bottom Line

The Bottom Line

Molina offers only Special Needs Plans for 2027. If you qualify, compare Molina’s SNP with others in your county; if not, choose a new plan during Annual Enrollment, October 15 to December 7, 2026.

Compare plans and enroll online

Frequently Asked Questions

➤ Does Molina offer Medicare Advantage plans for 2027?

Yes, but only Special Needs Plans. For 2027 Molina offers Medicare Advantage Special Needs Plans only, so its plans are generally open to people who qualify, such as those with both Medicare and Medicaid or certain conditions.

➤ Who can join a Molina Special Needs Plan?

People who meet the plan’s eligibility rules can join. A Dual Special Needs Plan requires both Medicare and Medicaid, while a Chronic Condition plan requires a qualifying condition. Availability varies by state and county. Enter your ZIP code to see what is offered.

➤ What if I am in a Molina plan that is not a Special Needs Plan?

If your Molina plan is not continuing, you should receive a non-renewal letter, and your coverage continues through December 31, 2026. You get a Special Enrollment Period to choose a new plan for January 1, 2027.

➤ Can I buy Medigap if my Molina plan ends?

Generally yes. When your Medicare Advantage plan leaves your area, you generally have a guaranteed issue right to buy certain Medigap plans without health questions, usually until 63 days after your coverage ends. Keep your non-renewal letter as proof.

➤ What is a Dual Special Needs Plan?

A Dual Special Needs Plan is a Medicare Advantage plan for people with both Medicare and Medicaid. It coordinates benefits from both programs and includes drug coverage. Your state Medicaid office can confirm your eligibility.

➤ Do Molina Special Needs Plans include drug coverage?

Yes. Special Needs Plans must include Part D drug coverage. For 2027 the maximum Part D deductible is $700 and the out-of-pocket cap is $2,400, although people with Extra Help often pay much less. Check your drugs on the formulary.

➤ Are other insurers going SNP-only for 2027?

Yes. Horizon BCBS New Jersey, Elderplan in New York and Presbyterian Health Plan in New Mexico also offer only Special Needs Plans for 2027, and Wellcare is SNP-only in Nevada and Ohio. Members of non-SNP plans with those insurers need new coverage.

➤ Can I change my Special Needs Plan during the year?

People with Medicaid or Extra Help may have more chances to change plans than other members. Check the current rules with Medicare or your State Health Insurance Assistance Program (SHIP) before you switch. Rules for these windows have changed in recent years.

➤ What benefits may Molina plans include?

Molina Special Needs Plans may include dental, vision, hearing, transportation or over-the-counter benefits, depending on the plan and area. Not all plans offer all benefits, so check the 2027 Evidence of Coverage. Ask Molina about limits and networks for each extra.

➤ When can I enroll in a Molina plan for 2027?

You can enroll during Annual Enrollment, October 15 to December 7, 2026, for coverage starting January 1, 2027, if you qualify. Dual-eligible members may also have Special Enrollment Periods during the year. Ask Medicare or your SHIP which window applies to you.

Have Questions?

Speak with a licensed insurance agent

1-833-641-4938

TTY users 711

Mon-Fri: 8am-9pm ET

Find & Compare Plans Online

Speak with a licensed insurance agent

1-833-641-4938TTY 711

Mon-Fri: 8am-9pm ET

ZRN Health & Financial Services, LLC, a Texas limited liability company

Russell Noga, licensed insurance agent
( Medicare Expert )

Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.

CompareMedicareAdvantagePlans.org
215 RR 620 South Austin, TX 78734

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