What Molina Is Exiting — and What It Is Keeping

Molina Healthcare announced in February 2026, alongside its fourth quarter and full year 2025 earnings report, that it will exit the traditional Medicare Advantage Prescription Drug (MAPD) product entirely for plan year 2027. The exit is nationwide — not limited to any single state. Molina will not offer standard individual Medicare Advantage plans with prescription drug coverage to new or renewing enrollees beginning January 1, 2027.

Critically, Molina is not exiting Medicare entirely. The company is pivoting its entire Medicare strategy toward dual-eligible Special Needs Plans — specifically D-SNPs, FIDE-SNPs (Fully Integrated Dual Eligible), and HIDE-SNPs (Highly Integrated Dual Eligible). Molina’s dual-eligible business is the product line it intends to grow, not abandon.

Why Molina Is Dropping MAPD: The Financial Reality

Molina’s decision is not a surprise to anyone watching the Medicare Advantage market closely. The company cited persistent underperformance in its traditional MAPD product as the direct driver — the MAPD business was dragging earnings by an estimated $2.50 per diluted share in adjusted earnings burden during 2026, according to Molina’s own investor disclosures. The company booked a $93 million intangible asset impairment in Q1 2026 directly related to the MAPD exit decision.

The MAPD product represented approximately $1 billion in annual premiums and roughly 80,000 members as of Molina’s 2025 annual filing. Molina’s Medicare segment medical cost ratio (MCR) ran at 89.8% in Q1 2026 — well above sustainable levels for a standard MA plan, where margins depend on keeping MCR meaningfully below 90%. Full-year 2026 Medicare segment MCR guidance was set at 94%, which is not a sustainable trajectory for a commodity MAPD product.

The strategic rationale is clear: Molina’s $5 billion Medicaid franchise and its dual-eligible book create a natural competitive advantage in D-SNPs and integrated dual-eligible products. Trying to compete in the standard individual MAPD market against UHC, Humana, and Aetna without that structural edge was a losing proposition. The exit allows Molina to concentrate resources where it actually wins.

Connecticut, Mississippi, and Nevada: State-Level Broker Impact

While Molina’s MAPD exit is nationwide, brokers in Connecticut, Mississippi, and Nevada face a particularly acute disruption. Molina was actively selling MAPD plans in all three states in 2026 and has existing enrollment in each market. Members who enrolled in a standard Molina MA-PD plan in any of these states will not have a Molina renewal option for 2027 and must select a new plan during AEP.

Connecticut

Connecticut is a notable market for Molina. The company acquired ConnectiCare for approximately $350 million — a significant investment in the state’s commercial and Medicare market. However, the MAPD exit applies to Molina’s traditional Medicare Advantage plans regardless of state. Connecticut has a competitive Medicare Advantage market with multiple established carriers including Aetna, ConnectiCare (now under Molina’s commercial umbrella), and UnitedHealthcare, among others. Hartford County alone had 29 Medicare Advantage plans available in 2026. Displaced Molina MAPD members in Connecticut have real alternatives to explore during AEP.

Mississippi

Molina had MAPD enrollment in Mississippi in 2026 under both its standard MAPD offerings and its Molina Medicare Complete Care (HMO D-SNP) — the D-SNP product, which serves dual-eligible members, continues. Brokers with standard MAPD clients in Mississippi need to confirm which product type each client holds. Dual-eligible clients currently in Molina’s D-SNP in Mississippi are not affected by the exit. Standard MAPD-only clients need to find a new plan. Competing carriers in Mississippi include Humana, Aetna, UHC, and regional plans — verify current availability in specific county markets before advising clients.

Nevada

Nevada’s Medicare Advantage market is concentrated heavily in Clark County (Las Vegas) and Washoe County (Reno). Molina was active in Nevada’s MAPD market in 2026. Brokers with Molina MAPD clients in Nevada should be conducting proactive outreach now — ahead of the ANOC delivery on September 30 — so that clients understand their plan is ending and you have their AEP review appointment scheduled before October 15. Key competing carriers in Nevada’s MA market include Humana, UHC, Aetna, and Anthem.

What Happens to Molina MAPD Members in 2027

Members who do not make an active enrollment change during AEP 2026 will not automatically transfer to a replacement plan. When a plan exits a market, members who take no action default to Original Medicare (Parts A and B) effective January 1, 2027. They do not retain their MA supplemental benefits, their MA network, or their Part D drug coverage unless they actively select a new plan.

This creates a significant health risk and coverage gap for members — particularly those who rely on MA supplemental benefits for dental, vision, hearing, OTC cards, or transportation. It is also a significant financial risk: members who default back to Original Medicare without a separate Part D plan face a potential late enrollment penalty for future drug plan enrollment.

Every Molina MAPD member in an exiting plan market receives a formal notice from Molina informing them that their plan is ending. They also receive a Special Enrollment Period (SEP) if their plan exits their service area, which allows them to enroll in a new plan even outside of the standard AEP window. However, brokers who proactively reach these clients during AEP are far better positioned to ensure a smooth, compliant transition — rather than waiting for members to call in crisis in January when their coverage has already lapsed.

Broker Action Plan: How to Protect Your Book of Business

Carrier exits are disruptive for clients — but they are pure opportunity for prepared brokers. Every displaced Molina MAPD member is a client who needs a new plan, a new broker conversation, and a new enrollment. Here is a step-by-step action plan:

Step 1 — Identify Every Molina MAPD Client in Your Book Now

Pull your CRM and filter every client currently enrolled in a Molina standard Medicare Advantage plan. Separate them from clients in Molina D-SNP (which continues). Your standard MAPD clients are your priority outreach list for AEP 2026. If you do not have a complete CRM record of client plan enrollments, use your carrier portal access or contact Molina’s broker services team to pull your production data.

Step 2 — Research Available Alternatives in Each Client’s County

Medicare Advantage plan availability is county-specific. Before contacting any client, know what plans are available in their county for 2027 — premiums, drug formularies, network providers, supplemental benefits, and star ratings. Use Medicare.gov’s plan finder and your carrier comparison tools to build a shortlist of realistic alternatives for each client market.

Step 3 — Contact Clients Before the ANOC Arrives

Molina members will receive an Annual Notice of Change (ANOC) by September 30 that confirms their plan is ending. Contact your Molina MAPD clients before that letter arrives. A brief, factual outreach — “I’m reaching out because your current Molina plan will not be continuing in 2027, and I want to make sure you’re set up with the right plan before AEP opens” — positions you as proactive and in command, rather than reactive and playing catch-up.

Step 4 — Schedule AEP Appointments and Collect Scopes of Appointment

For any client you plan to discuss specific plan options with, collect a Scope of Appointment (SOA) before the appointment. Under the new CMS 2027 marketing rules effective October 1, 2026, the 48-hour SOA waiting period has been eliminated — you can hold the appointment the same day the client completes the SOA. Schedule your Molina client appointments for the first week of AEP so enrollments can be submitted immediately.

Step 5 — Verify Your Carrier Contracting for Replacement Plans

If you plan to move Molina clients to plans from Aetna, Humana, UHC, or other carriers, confirm that you are contracted, appointed, certified, and ready-to-sell with each carrier before October 15. Carrier blackout periods for new certifications often close in September or October. If you need contracting help for any carrier, an FMO like Affordable Care Agents can fast-track your contracting appointment before AEP opens.

The Bigger Picture: Molina Is Not Alone

Molina’s MAPD exit is part of a sweeping industry-wide correction in the Medicare Advantage market. The industry-wide medical cost ratio spike of 2024 and 2025 — driven by higher utilization, deferred pandemic care, and CMS risk adjustment changes — pushed multiple carriers to reduce their MA footprints heading into 2027. Molina is exiting its entire MAPD line. Humana is exiting plans affecting approximately 600,000 members. Centene (WellCare) is cutting plans in multiple markets. Aetna announced it would stop paying broker commissions on certain MA plans beginning September 15, 2026.

For brokers, the broad lesson is this: the Medicare Advantage market is in active structural adjustment, and clients who had stable, low-cost plans for several years may find themselves in disrupted plans or exiting markets for AEP 2026. Every client is a potential review conversation. Not just Molina clients — but clients in any plan that is reducing benefits, raising premiums, cutting network providers, or exiting specific counties for 2027.

The brokers who will build the strongest books coming out of AEP 2026 are those who position themselves as proactive advisors — not order-takers waiting for clients to call. Use the carrier disruption environment to demonstrate your expertise and earn deeper client loyalty.

How Affordable Care Agents Helps Brokers Navigate Carrier Exits

Affordable Care Agents supports Medicare brokers nationwide in navigating carrier disruptions, exits, and AEP transitions. For brokers with Molina MAPD clients in Connecticut, Mississippi, Nevada, or any other state:

• Fast-track contracting with alternative carriers including Aetna, Humana, UHC, Cigna, Elevance, BCBS, and regional plans
• AHIP 2027 discount certification through the OIM partnership — complete your cert before carrier blackout deadlines close
• AEP preparation training covering the new October 1 CMS marketing rules, SOA changes, and compliance requirements
• Back-office support for enrollment submissions, SOA documentation, and client case management during AEP
• Agent recruiting support for agencies looking to expand their team ahead of the highest-volume selling period of the year

Frequently Asked Questions