When it comes to Medicaid providers in Texas, two big names stand out: Molina Healthcare and Superior Health Plan. But which one is the better choice for you?
In this comprehensive guide, we’ll compare and contrast Molina and Superior’s Medicaid plans in Texas, looking at key factors like provider networks, benefits, costs, and more.
A Brief Comparison Table
| Category | Molina Healthcare | Superior Health Plan |
| Provider Network | 50,000+ providers in TX | 69,000+ providers in TX |
| Covered Services | Medicaid standard benefits plus some extras like adult dental and vision | Medicaid standard benefits plus additional services like personal attendant care and home-delivered meals |
| Cost Sharing | $0 copay for non-emergency ER visits, $25 Rx copay cap annually | No copays for ER or prescriptions, covers transportation |
| Quality Ratings | 3 out of 5 stars from CMS | 3.5 out of 5 stars from CMS |
| Enrollment | Online or with a Molina agent | Online or with a Superior community representative |
| Key Advantages | Participates in Medicaid nationwide, $0 ER copay, some extra dental benefits | Larger TX provider network, enhanced benefits, no copays, higher CMS quality rating |
Overview Of Molina And Superior
First, let’s start with a quick rundown of each provider:
Molina Healthcare is a national managed care organization that provides Medicaid, Medicare, and ACA Marketplace plans across multiple states including Texas. In Texas, Molina offers several Medicaid and CHIP managed care plans, serving over 1 million members statewide.
Superior HealthPlan is a managed care company owned by Centene Corporation. Superior has operated in Texas for over 20 years, exclusively providing Medicaid and CHIP plans. Superior currently covers over 1.2 million Texans through Medicaid and CHIP.
Both Molina and Superior have contracts with the Texas Health and Human Services Commission (HHSC) to provide Medicaid and CHIP managed care plans in the state. Next, we’ll see how their Texas Medicaid plans compare.
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Detail Comparison Of Molina Healthcare And Superior Health Plan
Provider Networks
One of the most important factors in choosing a Medicaid or CHIP plan is the provider network. You want to make sure your doctors, specialists, hospitals and other providers are in-network. This ensures you pay the lowest costs when getting care.
Both Molina and Superior have broad provider networks in Texas. However, there are some key differences:
- Molina has a Texas-wide Medicaid network with over 50,000 providers. Their network includes major hospital systems like Texas Health Resources and Christus Health.
- Superior’s Medicaid provider network is even larger, with over 69,000 providers statewide. Superior partners with many top hospitals such as Children’s Health and MD Anderson Cancer Center.
When searching for specific doctors or facilities, be sure to check each plan’s online provider directory. Both Molina and Superior allow you to search by location and specialty to find in-network providers.
If keeping your current doctor is imperative, verify they are participating in the plan you choose. Changing plans may require finding new providers.
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Covered Services
Texas Medicaid and CHIP plans generally cover a comprehensive set of healthcare services, including:
- Doctor visits
- Hospital care
- Maternity care
- Mental healthcare
- Dental care
- Vision care
- Prescription drugs
However, some plans may offer additional benefits beyond the minimum required by state Medicaid. Here’s how Molina and Superior compare:
- Molina offers some extra benefits like adult dental services and $100 eyewear allowance annually.
- Superior goes beyond standard Medicaid, covering extra services like personal attendant care, transitional assistance, and up to 10 home-delivered meals after discharge from a hospital or nursing facility.
When evaluating plans, look closely at any value-added benefits that matter to you and your family. Superior seems to have a slight edge here.
Costs and Coverage Details
As Medicaid providers, neither Molina nor Superior charge premiums or deductibles. Some copays may apply.
Both plans also offer some cost-sharing protections:
- Molina has a $0 copay for non-emergency ER visits and an annual $25 copay cap for prescriptions.
- Superior does not charge copays for ER visits or prescriptions. They also offer a transportation benefit at no cost.
For families, Superior may mean lower out-of-pocket costs due to limited copays. However, both adhere to Medicaid guidelines capping expenses at 5% of your family’s annual income.
Medicaid eligibility and covered dependents are standardized statewide. All Medicaid members get the same basic coverage regardless of plan.
Quality of Care
When examining Medicaid providers, it helps to look at objective quality ratings:
- Molina gets 3 out of 5 stars from the Centers for Medicare and Medicaid Services (CMS).
- Superior earns a slightly higher rating of 3.5 stars from CMS.
Positive member satisfaction is another important indicator. For Superior, over 90% of members surveyed say they are happy with the plan. Molina also reports strong satisfaction based on internal surveys.
Both Molina and Superior appear to deliver quality care and positive experiences for Texas Medicaid recipients. Superior edges ahead slightly according to CMS ratings.
Enrollment Process
Signing up for Medicaid in Texas involves first applying to see if you meet income and eligibility guidelines. This can be done online through YourTexasBenefits.com or in person at local assistance offices.
If approved, you can select a Medicaid plan like Molina or Superior during open enrollment. Those deemed eligible outside of open enrollment can pick a plan immediately.
To enroll with a specific provider:
- Molina allows online enrollment or working with a Molina agent.
- Superior offers web-based enrollment or contacting a Superior community outreach representative.
The process is streamlined for both providers. You can even switch plans if you become dissatisfied during the coverage year.
Also watch the video about Molina!
Frequently Asked Questions (FAQ)
There are several top Medicaid providers in Texas, including Molina Healthcare, Superior Health Plan, UnitedHealthcare, and more. Superior Health Plan stands out with its large provider network, enhanced benefits, low out-of-pocket costs, and high ratings for care quality.
Yes, Superior HealthPlan is one of the main providers of Medicaid managed care plans in Texas. They have participated in Texas Medicaid for over 20 years.
Yes, Molina Healthcare is approved to offer Medicaid and CHIP health plans in Texas. They provide coverage to over 1 million Texans through Medicaid programs like STAR and STAR Kids.
No, Molina Healthcare does not participate in the Healthy Michigan Plan Medicaid expansion program in Michigan. However, they do offer Marketplace and Medicaid managed care plans in Michigan.
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Conclusion
Now let’s summarize the key differences between Molina and Superior:
Molina Advantages:
- Participates in Medicaid programs nationwide
- Offers $0 copay for non-emergency ER visits
- Provides adult dental benefits beyond basic Medicaid
Superior Advantages:
- Larger Texas Medicaid provider network
- Covers extra benefits like home-delivered meals
- No copays for ER or prescriptions
- Earns higher CMS quality rating
For many Texas Medicaid recipients, Superior HealthPlan may be the better choice. They offer a more robust provider network, lower out-of-pocket costs, additional benefits, and high marks for quality.
However, network size may not matter if your existing doctors participate with Molina. Weigh your personal priorities like provider access, prescription needs, and extra benefits.
Either Molina or Superior will cover you for essential Medicaid services in Texas. Picking the plan that best fits your situation can help you get the most out of your coverage.
