Molina Healthcare of Texas, Inc.

Name

Molina Healthcare of Texas, Inc.

Legal name

Molina Healthcare, Inc.

Website

https://molinahealthcare.com

Company type

Public

Founded year

1980

Operating status

Operating

Headcount range

101–250 employees

Ownership category

akta.pro rank

Product category

Managed Health Care Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114)

SIC

Hospital & Medical Service Plans (6324), Accident & Health Insurance (6321)

akta.pro industry

PRIMARYHLAEAMAI

Medicaid Managed Care HMOs

Healthcare & Life Sciences/Health Insurance & Managed Care/Health Maintenance Organizations (HMOs)

Keywords

• Managed health care
• Medicaid health plans
• Medicare Advantage plans
• Marketplace insurance
• Government-sponsored health coverage

Headquarters

HQ city

San Antonio, Texas

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

Operations, Personnel, Technology or R&D, Marketing or Sales, Others

Revenue model

1. Managed Care Premium Revenue: Molina Healthcare generates revenue primarily through managed care premiums received from government-sponsored health programs including Medicaid, Medicare, and Marketplace/Exchange plans. The company operates under risk-based contracts with state Medicaid programs and CMS for Medicare Advantage plans.
2. Medicare Advantage Plans: Medicare Advantage plans (Part C) that combine hospital, medical, and often prescription drug coverage under capitated arrangements with CMS.
3. Marketplace/Exchange Plans: Qualified health plans offered through state and federal health insurance Marketplaces, with premium subsidies available to eligible enrollees.

Go-to-market motion3 records

Distribution channels6 records

Marketing channels6 records

Core offering

Molina Healthcare of Texas, Inc. operates as a state-level managed health care plan providing government-sponsored health insurance to eligible Texans. The company offers Medicaid, Medicare Advantage, and ACA Marketplace health plans, supported by member digital tools (My Molina portal and mobile app), a provider network, and care coordination programs. It is a wholly-owned subsidiary of Molina Healthcare, Inc., a FORTUNE 500 managed care company.

Product overview

Molina Healthcare operates a multi-state managed health care organization offering Medicaid, Medicare, and Marketplace/Exchange health plans across 19 states. The core product portfolio includes government-sponsored health insurance (Medicaid for low-income individuals, Medicare Advantage for seniors, and ACA Marketplace plans) supported by digital member engagement tools including the My Molina member portal, My Molina mobile app, and Molina Help Finder. The company provides clinical support through Molina Clinical Policy and extends its mission through the MolinaCares Accord corporate responsibility initiative. Member services include pharmacy benefits, behavioral health resources via PsychHub, and care coordination through Molina Care Connections. For providers, Molina offers the Availity Essentials portal and interoperability APIs for third-party health applications.

Differentiator

Problem solved

Functional benefit

Brands

• My Molina: Member portal and mobile application for managing health care online
• Molina Mobile App
• Molina Marketplace
• Molina Healthy Rewards

Products and services

• Medicaid Health Plans Managed Medicaid plans providing medical services for children and adults with limited income and resources, offered across multiple states including Texas.
• Medicare Advantage Plans Medicare Advantage plans (Part C) for seniors aged 65+ and individuals with qualifying disabilities, including HMO, PPO, and Dual Eligible Special Needs Plan (D-SNP) options, combining hospital, medical, and often prescription drug coverage.
• Marketplace/Exchange Health Plans Qualified health plans offered through state and federal Health Insurance Marketplaces for individuals and families who do not qualify for Medicaid or Medicare, with premium subsidies available to eligible enrollees.

Quantifiable outcome

• 18 of Molina's Medicaid health plans are NCQA accredited
• +2 more outcomes

Segments6 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration11 records

AI capability4 records

Feature6 records

Partnerships

Seven partnerships are on record, tiered core and minor.

• Health SherpacoreTechnology or IntegrationMolina Healthcare participates as an Enhanced Direct Enrollment (EDE) entity through an agreement with CMS, allowing Molina and its authorized EDE partner Health Sherpa to submit consumer application information directly to Federally-facilitated Marketplaces without requiring consumers to use HealthCare.gov.
• PsychHubminorStrategic or Co-development PartnerMolina partnered with PsychHub to offer members free access to an online library of mental health videos covering topics from addiction and anxiety to eating disorders and insomnia.
• AvailitycoreTechnology or IntegrationAvaility Essentials portal serves as the provider portal for Molina Healthcare, replacing the Molina Provider portal. Providers use Availity for plan-specific information and transactions.
• Peninsula Community Health ServicesminorStrategic or Co-development PartnerThe MolinaCares Accord granted $75,000 to Peninsula Community Health Services to support deployment of a mobile mammography unit serving Kitsap, Mason, and rural Pierce counties in Washington.
• March of DimesminorStrategic or Co-development PartnerThe MolinaCares Accord presented $95,000 to March of Dimes in support of the Doula-Hospital Integration Program (D-HIP) in Chicago, Illinois.
• University of Nevada RenominorStrategic or Co-development PartnerThe MolinaCares Accord supported University of Nevada Reno with $225,000 to enhance behavioral health and workforce development initiatives.
• Idaho Community-Based OrganizationsminorStrategic or Co-development PartnerMolinaCares for Idaho Families Initiative invested $256,000 in more than 10 local community-based organizations to enhance access to care and improve health outcomes for Idahoans.

Scale indicators6 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Centene Corporation: Centene is the most directly comparable peer, with both companies being large publicly traded managed care organizations heavily concentrated in government-sponsored programs (Medicaid and Marketplace). Centene operates in similar state Medicaid contracts and competes head-to-head with Molina for state RFPs and Marketplace share.
• Humana Inc. Humana is one of the largest Medicare Advantage-focused insurers with growing Medicaid presence, competing directly with Molina for MA membership and dual-eligible (D-SNP) members across overlapping states. Both companies emphasize broker distribution channels for Medicare products.

Broad incumbents

• UnitedHealth Group: UnitedHealth is the largest US health insurer and a broad incumbent with significant Medicaid and Medicare Advantage footprints through UnitedHealthcare, plus vertically integrated provider assets via Optum. It is a key competitor for Molina's state Medicaid contracts and Marketplace plans, operating at meaningfully greater scale.
• Elevance Health: Elevance Health (formerly Anthem) operates Blue Cross Blue Shield plans across multiple states with substantial Medicaid (Anthem Blue Cross Blue Shield) and Medicare Advantage businesses. It competes with Molina on state Medicaid contracts and Medicare, though its overall portfolio spans commercial, employer, and specialty segments well beyond the government-subsidiary model.
• CVS Health (Aetna): CVS Health's Aetna segment offers Medicaid and Medicare Advantage products and is vertically integrated with retail pharmacies, MinuteClinics, and Oak Street Health primary care. It competes with Molina across Medicaid and Medicare markets while pursuing integrated care delivery that Molina lacks.
• The Cigna Group: Cigna operates Medicare Advantage and Marketplace plans (after divesting much of its Medicare business to HCSC), competing with Molina on Marketplace and select MA geographies. Its broader commercial and PBM (Express Scripts) portfolio makes it a broader incumbent rather than a direct government-program pure play.
• Kaiser Permanente: Kaiser Permanente operates an integrated, closed-network HMO model serving Medicaid, Medicare, and commercial members primarily in California and other Western states. While its vertically integrated model differs from Molina's broader-network approach, it competes for Medicaid and MA membership in shared geographies.

Regional players

• Health Care Service Corporation (HCSC): HCSC operates Blue Cross Blue Shield plans in five core states (TX, IL, MT, NM, OK) and recently acquired Cigna's Medicare business. As a major competitor specifically in the Texas market alongside Molina's Texas subsidiary, HCSC competes directly on state Medicaid contracts and Marketplace plans.

Emerging players

• Alignment Healthcare: Alignment Healthcare is a technology-enabled Medicare Advantage insurer focused on senior members in select Western and Southwestern states. It competes with Molina for MA membership in California, Nevada, and other overlapping geographies using tech-forward care coordination.
• Clover Health: Clover Health is a smaller, technology-focused Medicare Advantage insurer serving select counties with a primary care-centric model. While much smaller than Molina, it competes for MA membership in overlapping markets and represents the type of niche, tech-enabled MCO challenging traditional players.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks5 records

Key highlights7 records

Customer concentration

• Xtwitter.com/molinahealth
• Facebookfacebook.com/MolinaHealth
• LinkedInlinkedin.com/company/molina-healthcare-of-texas-inc-
• Instagraminstagram.com/molinahealth

Compliance5 records

Revenue estimate

Valuation estimate

Number of profiles

Subsidiaries7 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Molina Healthcare of Texas, Inc.