If you’re shopping for Affordable Care Act (ACA) plans, Medicaid coverage, or Medicare Advantage options in states like Washington or Alaska, you’ve likely come across two providers: Premera Blue Cross and Molina Healthcare.
Both companies aim to deliver affordable, quality care—but their approach, coverage focus, and provider networks vary significantly. In this in-depth comparison of Premera Blue Cross vs Molina Healthcare, we explore their strengths in plan types, affordability, provider access, Medicaid eligibility, and customer satisfaction to help you make an informed decision in 2025.
Company Overview
Premera Blue Cross
Premera Blue Cross is a nonprofit regional health insurer affiliated with the Blue Cross Blue Shield Association, serving Washington and Alaska. Known for strong PPO options and access to a broad network of doctors, Premera serves both individuals and large employer groups.
Key Highlights:
- Serves over 2 million people in the Pacific Northwest
- Offers ACA Marketplace, group, and Medicare Advantage PPO plans
- Known for access to top hospitals like UW Medicine, Virginia Mason, and Providence
- Strong PPO network with out-of-state BCBS reciprocity
Molina Healthcare
Molina Healthcare is a national health insurer with a focus on Medicaid, Medicare Advantage, and low-cost ACA plans. Operating in 19+ states, Molina is known for delivering affordable managed care to underserved communities.
Key Highlights:
- Serves over 5 million members nationwide
- Specializes in Medicaid, D-SNPs, and subsidized ACA plans
- Expanding presence in states like Washington, California, Texas, and Florida
- Known for care coordination and local partnerships
Coverage Area & Availability (2025)
| Feature | Premera Blue Cross | Molina Healthcare |
| States Served | Washington, Alaska | 19+ states (including WA, CA, TX, FL) |
| ACA Marketplace Plans | Yes (WA, AK only) | Yes (many states, including WA) |
| Medicaid | No | Yes (state-based Medicaid in multiple states) |
| Medicare Advantage Plans | Yes (PPO in WA, AK) | Yes (HMO, D-SNP in 20+ states) |
| Employer Coverage | Yes (strong large-group focus) | No |
Verdict: Premera is more regionally focused with strong PPO access in Washington and Alaska, while Molina serves low-income individuals across a much larger national footprint.
ACA Marketplace Plan Comparison (Washington, 2025)
| Feature | Premera Blue Cross | Molina Healthcare |
| Monthly Premiums | $0 – $600+ (after subsidies) | $0 – $500+ (after subsidies) |
| Deductibles | $1,000 – $7,500+ | $1,200 – $7,000+ |
| Out-of-Pocket Max | $5,000 – $9,450 | $4,500 – $9,100 |
| Virtual Care | Included via Premera app | Included (Molina Telehealth or Teladoc) |
| PPO Access | Yes | No (EPO or HMO network) |
| Adult Dental/Vision | Optional add-ons | Available in select plans |
Verdict: Premera offers more provider flexibility with PPOs, while Molina typically has lower costs and streamlined managed care for lower-income consumers.
Medicare Advantage Comparison
| Feature | Premera Blue Cross (PPO) | Molina Healthcare (HMO/D-SNP) |
| Plan Type | PPO only (select WA, AK counties) | HMO & D-SNP in multiple states |
| Prescription Coverage (MAPD) | Included | Included |
| Dental, Vision, Hearing | Included (varies by plan) | Included (generous in D-SNP plans) |
| OTC & Grocery Benefits | Select plans only | Included in many plans |
| CMS Star Ratings (2024) | 3.5 – 4.5 stars | 3.0 – 4.0 stars |
| Fitness/Wellness Benefits | Yes (fitness & mental health) | Yes (Silver&Fit, care coordinators) |
Verdict: Premera offers more flexibility through PPOs, while Molina shines in low-cost, high-benefit Medicare Advantage plans for dual-eligible individuals.
Medicaid Services
| Feature | Premera Blue Cross | Molina Healthcare |
| Traditional Medicaid | Not offered | Yes (WA, TX, FL, CA, IL, etc.) |
| Long-Term Services | N/A | Yes (in many state Medicaid programs) |
| Children’s Health Programs | N/A | Yes (CHIP and pediatric preventive programs) |
| Care Management | N/A | Yes (for complex needs and chronic conditions) |
| Behavioral Health | Limited | Integrated into many Medicaid plans |
Verdict: Molina is the clear leader in Medicaid coverage, especially in Washington and other large states.
Provider Networks & Access
| Category | Premera Blue Cross | Molina Healthcare |
| Primary Care Providers | Large regional network + national PPO | Limited to local HMO networks |
| Specialist Access | No referral needed (PPO plans) | Referrals required (HMO model) |
| Hospital Affiliations | Includes UW Medicine, Providence, etc. | Partnered with local safety-net hospitals |
| Out-of-Network Coverage | Yes (PPO) | No (HMO only) |
Verdict: Premera wins on flexibility and provider access, while Molina focuses on managed in-network care coordination.
Technology & Member Tools
| Feature | Premera Blue Cross | Molina Healthcare |
| Mobile App | Yes – claims, telehealth, ID card | Yes – basic member features & care access |
| 24/7 Telehealth | Yes (via Premera virtual care) | Yes (Teladoc or local telehealth services) |
| Wellness & Rewards | Limited | Available in some Medicare/Medicaid plans |
| Language & Accessibility | Multilingual + ADA compliant | Strong support for diverse, low-income users |
Verdict: Both offer solid digital tools, though Molina prioritizes accessibility and community care, while Premera focuses on convenience and provider choice.
Pros and Cons
Premera Blue Cross
Pros:
- PPO flexibility with out-of-network coverage
- Strong regional provider network in WA and AK
- Covered on the ACA Exchange and Medicare Advantage
- Access to top-tier hospitals and specialists
Cons:
- Only available in 2 states
- Limited Medicaid and low-income support programs
Molina Healthcare
Pros:
- Strong presence in Medicaid and ACA plans
- Low-cost premiums and deductibles
- Great for dual-eligible Medicare/Medicaid members
- Available in 19+ states
Cons:
- HMO-only (no out-of-network coverage)
- Mixed CMS Star Ratings
- Smaller provider networks
Which Should You Choose?
Choose Premera Blue Cross if:
- You live in Washington or Alaska
- You want a PPO plan with broad provider access
- You value flexibility in choosing doctors or specialists
- You’re looking for employer or Medicare PPO coverage
Choose Molina Healthcare if:
- You qualify for Medicaid, D-SNP, or ACA subsidies
- You prefer lower costs and coordinated care
- You live in one of Molina’s active states
- You want access to OTC/grocery benefits and wellness incentives
Both Premera Blue Cross and Molina Healthcare serve very different member needs. Premera is best for consumers seeking PPO flexibility and access to top providers in the Northwest, while Molina is ideal for low-income individuals and families needing affordable, managed care through Medicaid or ACA plans.
Before enrolling:
- Compare plans on HealthCare.gov, Medicare.gov, or your state exchange
- Review provider networks, formulary lists, and Star Ratings
- Check eligibility for subsidies or Medicaid programs