InsuranceComplaintCheck

Molina Healthcare — Insurance Complaint Report

Molina Healthcare: High Complaints on Billing and Network Issues

Key Metrics

  • Total Complaints: 1,344
  • NAIC Complaint Ratio: 1.28
  • Market Share: 1.5%
  • AI Risk Score: 85/100
  • Most Recent Complaint: 2024-05-18

AI Insurer Analysis

Molina Healthcare has accumulated 1,344 insurance complaints on record. Their NAIC complaint ratio of 1.28 is above average, meaning they receive more complaints than expected for an insurer of their market size. With approximately 1.5% market share, Molina Healthcare is a smaller player in the insurance market. The most common complaint categories are: health (20). Molina Healthcare has a high complaint ratio, with a significant number of billing and network disputes. The insurer's complaint profile indicates frequent issues with claim denials and prior authorizations. Recent complaints are concentrated in health coverage, particularly in billing and network access. Trend shows increasing complaints in billing and network access issues. Areas of concern include: Frequent claim denials and prior authorization issues; High number of billing errors and network disputes. On the positive side: Recent focus on health coverage improvements.

Risk Breakdown

  • regulatoryActions: none
  • complaintRatio: high
  • claimDenialRate: high
  • responseTime: fair

Red Flags

  • Frequent claim denials and prior authorization issues
  • High number of billing errors and network disputes

Green Flags

  • Recent focus on health coverage improvements

Consumer Tips

When dealing with Molina Healthcare, keep these practical tips in mind: 1. Check your network coverage before choosing a provider. 2. Review your billing statements for accuracy and discrepancies. 3. Ensure you understand the prior authorization process for necessary treatments. Before purchasing a policy, compare Molina Healthcare's complaint ratio (1.28, above average) with competitors offering similar coverage. Always read the full policy document, paying attention to exclusions and limitations. Document all communications with the insurer in writing. If you experience a dispute, file a complaint with your state Department of Insurance — it is free and often results in faster resolution.

Trend Analysis

Trend shows increasing complaints in billing and network access issues.

Frequently Asked Questions about Molina Healthcare

Is Molina Healthcare a good insurance company?

Molina Healthcare has 1,344 complaints on record. Their NAIC complaint ratio is 1.28, which is above average. They hold approximately 1.5% market share. A complaint ratio below 1.00 indicates fewer complaints than expected for a company of this size; above 1.00 indicates more.

What are the most common complaints about Molina Healthcare?

The most common complaint categories for Molina Healthcare are: health (20). The leading specific issues are: Billing error (5), Network dispute (5), Prior authorization (3).

How does Molina Healthcare compare to competitors?

Molina Healthcare's NAIC complaint ratio of 1.28 is above average. Companies with ratios below 1.00 receive fewer complaints relative to their size. When comparing insurers, also consider financial strength ratings, coverage options, and premium pricing alongside complaint data.

Should I file a DOI complaint against Molina Healthcare?

If you have an unresolved dispute with Molina Healthcare, filing a complaint with your state Department of Insurance (DOI) is a free and effective option. Steps: (1) Gather all documentation including your policy, correspondence, and claim records. (2) Contact your state DOI — most Molina Healthcare complaints come from Wisconsin. (3) File online or by mail. (4) The DOI typically responds within 30-45 days.

Are Molina Healthcare complaints getting better or worse?

Molina Healthcare has 1,344 total complaints. In the most recent data, 20 complaints were recorded across 1 coverage categories. Check the NAIC Consumer Information Source for the most current complaint ratio trends.

What insurance companies have the lowest complaint ratios?

Insurance companies with the lowest complaint ratios typically include mutual insurers and member-owned companies. To find alternatives to Molina Healthcare, compare NAIC complaint ratios for companies offering the same coverage types (health, etc.). Your state DOI website provides complaint data specific to companies licensed in your state.

Has Molina Healthcare been fined or sanctioned by insurance regulators?

Regulatory action information is available through your state Department of Insurance and the NAIC. Molina Healthcare has 1,344 consumer complaints on record with a complaint ratio of 1.28. For specific regulatory actions, check the NAIC Regulatory Actions database and your state DOI enforcement records.

Which states have the most complaints against Molina Healthcare?

The states with the most complaints against Molina Healthcare are: Wisconsin (2), Wyoming (1), Montana (1), Utah (1), Oklahoma (1). This distribution may reflect the company's market presence in those states rather than indicating worse service in specific locations.

What patterns emerge from Molina Healthcare's complaint data?

Molina Healthcare has a high complaint ratio, indicating potential issues with customer service and claim processing.

How does Molina Healthcare handle claims compared to peers?

Billing errors and network disputes are the most frequent complaint types, suggesting problems with transparency and accessibility.

What is the complaint trend for Molina Healthcare?

Trend shows increasing complaints in billing and network access issues.

What should prospective policyholders know about Molina Healthcare?

Recent complaints are concentrated in health coverage, highlighting areas for improvement in service delivery.

Recent Complaints Against Molina Healthcare

Molina Healthcare Complaints by State

Molina Healthcare Complaints by Coverage Type

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This analysis is based on NAIC complaint data and AI interpretation. Not legal, financial, or insurance advice.