Cost sharing is standardized in California. Covered California sets identical deductibles, copays and out-of-pocket maximums for every carrier within a metal tier, so what actually differs between carriers is premium, network and service area. See the 2026 side-by-side benefit designs, including the Enhanced Silver plans available under about 250% of the poverty level.
Molina Healthcare
Apply Online Now
| Catastrophic HMO | |
| Deductible (Individual/Family) | $10,600 |
| Out-of-Pocket Maximum (Individual/Family) | $10,600 |
| Doctor Visit | |
| Primary Care Office Visit | First 3 visits at $0 copay before deductible |
| Specialty Care Office Visit | 0% coinsurance after deductible |
| Other Practitioner Office Visit | $0 copay before deductible |
| Preventive Care/Screening/Immunization | No charge |
| Tests | |
| Lab Tests | 0% coinsurance after deductible |
| X-Rays and Diagnostic Imaging | 0% coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs) | 0% coinsurance after deductible |
| Drugs | |
| Tier 1 (Most Generic Drugs) | 0% coinsurance after deductible |
| Tier 2 (Preferred Brand Drugs) | 0% coinsurance after deductible |
| Tier 3 (Non-Preferred Brand Drugs) | 0% coinsurance after deductible |
| Tier 4 (Specialty Drugs) | 0% coinsurance after deductible |
| Outpatient Services | |
| Outpatient Facility Fee | 0% coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | 0% coinsurance after deductible |
| Outpatient Services Office Visits | 0% coinsurance after deductible |
| ER & Urgent Care | |
| Emergency Room Facility Fee | 0% coinsurance after deductible |
| Emergency Transportation | 0% coinsurance after deductible |
| Urgent Care | $0 copay before deductible |
| Emergency Room Professional Fee | No charge |
| Hospital | |
| Inpatient Hospital Services | 0% coinsurance after deductible |
| Inpatient Physician and Surgical Services | 0% coinsurance after deductible |
| Mental/Behavioral Health Inpatient Facility Fee | 0% coinsurance after deductible |
| Mental/Behavioral Health Inpatient Professional Fee | 0% coinsurance after deductible |
| Substance Use Disorder Outpatient Services | $0 copay before deductible |
| Pregnancy | |
| Prenatal Care | No charge |
| Delivery and Maternity Care Inpatient Facility Fee | 0% coinsurance after deductible |
| Delivery and Maternity Care Inpatient Professional Fee | 0% coinsurance after deductible |
| Other Special Needs | |
| Home Health Care Services | 0% coinsurance after deductible |
| Outpatient Rehabilitation Services | 0% coinsurance after deductible |
| Skilled Nursing Facility | 0% coinsurance after deductible |
| Durable Medical Equipment | 0% coinsurance after deductible |
| Hospice Services | 0% coinsurance after deductible |
| Acupuncture | $0 copay before deductible |
| Rehabilitative Speech Therapy | 0% coinsurance after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | 0% coinsurance after deductible |
| Well Baby Visits and Care | No charge |
| Allergy Testing | 0% coinsurance after deductible |
| Diabetes Education | No charge |
| Nutritional Counseling | Not covered |
| Children’s Vision | |
| Eye Exam for Children | No charge |
| Eyeglasses for Children | 0% coinsurance after deductible |
| Children’s Dental | |
| Child Filling – One Surface | 0% coinsurance after deductible |
| Child Dental Checkup | No charge |
| Child Root Canal – Molar | 0% coinsurance after deductible |
| Child Medically Necessary Orthodontia | 0% coinsurance after deductible |
Bronze
| Bronze 60 HMO | |
| Deductible (Individual/Family) | $6,300 |
| Out-of-Pocket Maximum (Individual/Family) | $6,800 |
| Doctor Visit | |
| Primary Care Office Visit | First 3 visits at $75 copay before deductible |
| Specialty Care Office Visit | $105 copay before deductible |
| Other Practitioner Office Visit | $75 copay beore deductible |
| Preventive Care/Screening/Immunization | No charge |
| Tests | |
| Lab Tests | $40 copay |
| X-Rays and Diagnostic Imaging | 100% coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs) | 100% coinsurance after deductible |
| Drugs | |
| Tier 1 (Most Generic Drugs) | 100% coinsurance after deductible |
| Tier 2 (Preferred Brand Drugs) | 100% coinsurance after deductible |
| Tier 3 (Non-Preferred Brand Drugs) | 100% coinsurance after deductible |
| Tier 4 (Specialty Drugs) | 100% coinsurance after deductible |
| Outpatient Services | |
| Outpatient Facility Fee | 100% coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | 100% coinsurance after deductible |
| Outpatient Services Office Visits | 100% coinsurance after deductible |
| ER & Urgent Care | |
| Emergency Room Facility Fee | 100% coinsurance after deductible |
| Emergency Transportation | 100% coinsurance after deductible |
| Urgent Care | $75 copay before deductible |
| Emergency Room Professional Fee | No charge |
| Hospital | |
| Inpatient Hospital Services | 100% coinsurance after deductible |
| Inpatient Physician and Surgical Services | 100% coinsurance after deductible |
| Mental/Behavioral Health Inpatient Facility Fee | $75 copay before deductible |
| Mental/Behavioral Health Inpatient Professional Fee | 100% coinsurance after deductible |
| Substance Use Disorder Outpatient Services | $75 copay before deductible |
| Pregnancy | |
| Prenatal Care | No charge |
| Delivery and Maternity Care Inpatient Facility Fee | 100% coinsurance after deductible |
| Delivery and Maternity Care Inpatient Professional Fee | 100% coinsurance after deductible |
| Other Special Needs | |
| Home Health Care Services | 100% coinsurance after deductible |
| Outpatient Rehabilitation Services | $75 copay |
| Skilled Nursing Facility | 100% coinsurance after deductible |
| Durable Medical Equipment | 100% coinsurance after deductible |
| Hospice Services | No Charge |
| Acupuncture | $75 copay before deductible |
| Rehabilitative Speech Therapy | $75 copay |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $75 copay |
| Well Baby Visits and Care | No charge |
| Allergy Testing | $105 copay before deductible |
| Diabetes Education | No charge |
| Nutritional Counseling | Not covered |
| Children’s Vision | |
| Eye Exam for Children | No charge |
| Eyeglasses for Children | No charge |
| Children’s Dental | |
| Child Filling – One Surface | $25 copay |
| Child Dental Checkup | No charge |
| Child Root Canal – Molar | $300 copay |
| Child Medically Necessary Orthodontia | $1,000 copay |
Silver
| Silver 70 HMO | |
| Deductible (Individual/Family) | $2,500 |
| Out-of-Pocket Maximum (Individual/Family) | $6,800 |
| Doctor Visit | |
| Primary Care Office Visit | $35 copay |
| Specialty Care Office Visit | $70 copay |
| Other Practitioner Office Visit | $35 copay |
| Preventive Care/Screening/Immunization | No charge |
| Tests | |
| Lab Tests | $35 copay |
| X-Rays and Diagnostic Imaging | $70 copay |
| Imaging (CT/PET Scans, MRIs) | $300 copay |
| Drugs | |
| Tier 1 (Most Generic Drugs) | $15 copay |
| Tier 2 (Preferred Brand Drugs) | $55 copay after deductible |
| Tier 3 (Non-Preferred Brand Drugs) | $80 copay after deductible |
| Tier 4 (Specialty Drugs) | 20% coinsurance after deductible |
| Outpatient Services | |
| Outpatient Facility Fee | 20% coinsurance |
| Outpatient Surgery Physician/Surgical Services | 20% coinsurance |
| Outpatient Services Office Visits | 20% coinsurance |
| ER & Urgent Care | |
| Emergency Room Facility Fee | $350 copay |
| Emergency Transportation | $250 copay after deductible |
| Urgent Care | $35 copay |
| Emergency Room Professional Fee | No charge |
| Hospital | |
| Inpatient Hospital Services | 20% coinsurance after deductible |
| Inpatient Physician and Surgical Services | 20% coinsurance after deductible |
| Mental/Behavioral Health Inpatient Facility Fee | $35 copay |
| Mental/Behavioral Health Inpatient Professional Fee | 20% coinsurance after deductible |
| Substance Use Disorder Outpatient Services | $35 copay |
| Pregnancy | |
| Prenatal Care | No charge |
| Delivery and Maternity Care Inpatient Facility Fee | 20% coinsurance after deductible |
| Delivery and Maternity Care Inpatient Professional Fee | 20% coinsurance after deductible |
| Other Special Needs | |
| Home Health Care Services | $45 copay |
| Outpatient Rehabilitation Services | $35 copay |
| Skilled Nursing Facility | 20% coinsurance after deductible |
| Durable Medical Equipment | 20% coinsurance |
| Hospice Services | No Charge |
| Acupuncture | $35 copay |
| Rehabilitative Speech Therapy | $35 copay |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $75 copay |
| Well Baby Visits and Care | No charge |
| Allergy Testing | $70 copay |
| Diabetes Education | No charge |
| Nutritional Counseling | Not covered |
| Children’s Vision | |
| Eye Exam for Children | No charge |
| Eyeglasses for Children | No charge |
| Children’s Dental | |
| Child Filling – One Surface | $25 copay |
| Child Dental Checkup | No charge |
| Child Root Canal – Molar | $300 copay |
| Child Medically Necessary Orthodontia | $1,000 copay |
Gold
| Gold 70 HMO | |
| Deductible (Individual/Family) | $0 |
| Out-of-Pocket Maximum (Individual/Family) | $6,750 |
| Doctor Visit | |
| Primary Care Office Visit | $30 copay |
| Specialty Care Office Visit | $55 copay |
| Other Practitioner Office Visit | $30 copay |
| Preventive Care/Screening/Immunization | No charge |
| Tests | |
| Lab Tests | $35 copay |
| X-Rays and Diagnostic Imaging | $55 copay |
| Imaging (CT/PET Scans, MRIs) | 20% coinsurance |
| Drugs | |
| Tier 1 (Most Generic Drugs) | $15 copay |
| Tier 2 (Preferred Brand Drugs) | $55 copay |
| Tier 3 (Non-Preferred Brand Drugs) | $75 copay |
| Tier 4 (Specialty Drugs) | 20% coinsurance |
| Outpatient Services | |
| Outpatient Facility Fee | 20% coinsurance |
| Outpatient Surgery Physician/Surgical Services | 20% coinsurance |
| Outpatient Services Office Visits | 20% coinsurance |
| ER & Urgent Care | |
| Emergency Room Facility Fee | $325 copay |
| Emergency Transportation | $250 copay |
| Urgent Care | $30 copay |
| Emergency Room Professional Fee | No charge |
| Hospital | |
| Inpatient Hospital Services | 20% coinsurance |
| Inpatient Physician and Surgical Services | 20% coinsurance |
| Mental/Behavioral Health Inpatient Facility Fee | 20% coinsurance |
| Mental/Behavioral Health Inpatient Professional Fee | 20% coinsurance |
| Substance Use Disorder Outpatient Services | $30 copay |
| Pregnancy | |
| Prenatal Care | No charge |
| Delivery and Maternity Care Inpatient Facility Fee | 20% coinsurance |
| Delivery and Maternity Care Inpatient Professional Fee | 20% coinsurance |
| Other Special Needs | |
| Home Health Care Services | 20% coinsurance |
| Outpatient Rehabilitation Services | $30 copay |
| Skilled Nursing Facility | 20% coinsurance |
| Durable Medical Equipment | 20% coinsurance |
| Hospice Services | No Charge |
| Acupuncture | $30 copay |
| Rehabilitative Speech Therapy | $30 copay |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $30 copay |
| Well Baby Visits and Care | No charge |
| Allergy Testing | $55 copay |
| Diabetes Education | No charge |
| Nutritional Counseling | Not covered |
| Children’s Vision | |
| Eye Exam for Children | No charge |
| Eyeglasses for Children | No charge |
| Children’s Dental | |
| Child Filling – One Surface | $25 copay |
| Child Dental Checkup | No charge |
| Child Root Canal – Molar | $300 copay |
| Child Medically Necessary Orthodontia | $1,000 copay |
Platinum
| Platinum 90 HMO | |
| Deductible (Individual/Family) | $0 |
| Out-of-Pocket Maximum (Individual/Family) | $4,000 |
| Doctor Visit | |
| Primary Care Office Visit | $15 copay |
| Specialty Care Office Visit | $40 copay |
| Other Practitioner Office Visit | $15 copay |
| Preventive Care/Screening/Immunization | No charge |
| Tests | |
| Lab Tests | $20 copay |
| X-Rays and Diagnostic Imaging | $40 copay |
| Imaging (CT/PET Scans, MRIs) | 10% coinsurance |
| Drugs | |
| Tier 1 (Most Generic Drugs) | $5 copay |
| Tier 2 (Preferred Brand Drugs) | $15 copay |
| Tier 3 (Non-Preferred Brand Drugs) | $25 copay |
| Tier 4 (Specialty Drugs) | 10% coinsurance |
| Outpatient Services | |
| Outpatient Facility Fee | 10% coinsurance |
| Outpatient Surgery Physician/Surgical Services | 10% coinsurance |
| Outpatient Services Office Visits | 10% coinsurance |
| ER & Urgent Care | |
| Emergency Room Facility Fee | $150 copay |
| Emergency Transportation | $150 copay |
| Urgent Care | $15 copay |
| Emergency Room Professional Fee | No charge |
| Hospital | |
| Inpatient Hospital Services | 10% coinsurance |
| Inpatient Physician and Surgical Services | 10% coinsurance |
| Mental/Behavioral Health Inpatient Facility Fee | 10% coinsurance |
| Mental/Behavioral Health Inpatient Professional Fee | 10% coinsurance |
| Substance Use Disorder Outpatient Services | $15 copay |
| Pregnancy | |
| Prenatal Care | No charge |
| Delivery and Maternity Care Inpatient Facility Fee | 10% coinsurance |
| Delivery and Maternity Care Inpatient Professional Fee | 10% coinsurance |
| Other Special Needs | |
| Home Health Care Services | 10% coinsurance |
| Outpatient Rehabilitation Services | $15 copay |
| Skilled Nursing Facility | 10% coinsurance |
| Durable Medical Equipment | 10% coinsurance |
| Hospice Services | No Charge |
| Acupuncture | $15 copay |
| Rehabilitative Speech Therapy | $15 copay |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $15 copay |
| Well Baby Visits and Care | No charge |
| Allergy Testing | $40 copay |
| Diabetes Education | No charge |
| Nutritional Counseling | Not covered |
| Children’s Vision | |
| Eye Exam for Children | No charge |
| Eyeglasses for Children | No charge |
| Children’s Dental | |
| Child Filling – One Surface | $25 copay |
| Child Dental Checkup | No charge |
| Child Root Canal – Molar | $300 copay |
| Child Medically Necessary Orthodontia | $1,000 copay |
Apply Online Now
2026 Molina Healthcare of California plans & member ratings
Molina Healthcare offers individual HMO plans through Covered California with a strong Los Angeles County community-provider footprint, usually at low premiums. In California, Covered California standardizes cost-sharing, so the deductible and out-of-pocket maximum for a given metal tier are the same at every carrier – the real differences are the network and the plan type. Figures below are the 2026 standardized single/individual medical values; premiums vary by age and county.
Gold 80 HMOPopular
No-deductible Gold HMO on Molina's network.
Metal level
Gold
Network
Molina HMO
Plan type
HMO
Deductible (single)
$0
Out-of-pocket max (single)
$9,200
HSA-eligible
No
Rate this plan
Rate all four categories – Cost, Plan Value, Customer Service and Network Size – to unlock submit. Comment optional. A first name or county are shown with your review; leave them blank to stay anonymous.
Baseline: 3.2 / 5 – seeded from CMS quality ratings and public member reviews; updates as visitor ratings come in.
Silver 70 HMOBest value
Standardized Silver HMO; strongest value with subsidies.
Metal level
Silver
Network
Molina HMO
Plan type
HMO
Deductible (single)
$5,200 (medical)
Out-of-pocket max (single)
$9,800
HSA-eligible
No
Rate this plan
Rate all four categories – Cost, Plan Value, Customer Service and Network Size – to unlock submit. Comment optional. A first name or county are shown with your review; leave them blank to stay anonymous.
Baseline: 3.4 / 5 – seeded from CMS quality ratings and public member reviews; updates as visitor ratings come in.
Bronze 60 HMOLowest premium
Standardized Bronze HMO for the lowest monthly premium.
Metal level
Bronze
Network
Molina HMO
Plan type
HMO
Deductible (single)
$5,800 (medical)
Out-of-pocket max (single)
$9,800
HSA-eligible
No
Rate this plan
Rate all four categories – Cost, Plan Value, Customer Service and Network Size – to unlock submit. Comment optional. A first name or county are shown with your review; leave them blank to stay anonymous.
Baseline: 3.2 / 5 – seeded from CMS quality ratings and public member reviews; updates as visitor ratings come in.
Platinum 90 HMORichest coverage
No-deductible Platinum HMO with the lowest out-of-pocket max.
Metal level
Platinum
Network
Molina HMO
Plan type
HMO
Deductible (single)
$0
Out-of-pocket max (single)
$5,000
HSA-eligible
No
Rate this plan
Rate all four categories – Cost, Plan Value, Customer Service and Network Size – to unlock submit. Comment optional. A first name or county are shown with your review; leave them blank to stay anonymous.
Baseline: 3.1 / 5 – seeded from CMS quality ratings and public member reviews; updates as visitor ratings come in.
Molina & California rate history
| Plan year | CA individual market (avg) | This carrier (approved) |
|---|---|---|
| 2019 | +8.7% | — |
| 2020 | +0.8% | — |
| 2021 | +0.5% | — |
| 2022 | +1.8% | — |
| 2023 | +5.6% | — |
| 2024 | +9.6% | — |
| 2025 | +7.9% | — |
| 2026 | +10.3% | +14.7% |
| 2027 (preliminary) | +9.9% | — |
Sources: Covered California 2026 rate announcement and standardized benefit designs; per-carrier 2026 change from Covered California. Statewide column is the Covered California individual-market weighted average.
Molina on price – check the network.
Molina is often among the lowest-premium options in LA, but its network is built around community clinics – confirm your doctors are in-network first. A licensed agent can compare it on Covered California at your ZIP, free. Call (855) 847-7020.