Molina Healthcare’s Medicare membership slipped to 222,000 on September 30 from 262,000 at the end of last year, as the insurer prepares to drop its traditional Medicare Advantage prescription drug plan. The company has told investors it will exit that product for 2027 and concentrate on members who have both Medicare and Medicaid. Anyone in a plan that is leaving needs to act before the December 7 enrollment deadline.
What Molina reported on its Medicare line
The Medicare row of the third-quarter membership table reads 222,000 on September 30, 2026, 262,000 on December 31, 2025 and 266,000 on September 30, 2025. The figure covers all Medicare members, including those who also have Medicaid. Molina did not say in the release how many of the lost members were in the plan it is exiting.
Dollars held steady even as people left. Medicare premium revenue was $1,616 million in the quarter, against $1,610 million a year earlier. Medical margin rose to $113 million from $103 million, and the medical care ratio, the share of premiums spent on members’ care, improved to 93.0% from 93.6%.
Medicare is the smallest of Molina’s big lines by members. The 222,000 Medicare members are under 5% of the company’s 4,862,000 total, and Medicare premiums of $1,616 million are about one-fifth of the $8,199 million Medicaid brought in. The reason Medicare matters to the company is not volume but the choice it has now made about which Medicare members to keep.
The plan Molina is leaving behind
The release says the traditional Medicare Advantage prescription drug product, known as MAPD, is being exited for 2027 because it “does not align with the Company’s strategic shift” toward dual-eligible members. Molina recorded a $93 million impairment, equal to $1.82 a share, tied to the decision. The company says it will focus exclusively on dual eligible members in Medicare.
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The plan has also been a drag on this year’s profit. Molina’s reaffirmed 2026 guidance includes a loss of $1.00 a share from MAPD, on top of a $1.50 a share loss from its new Florida Medicaid contract. Even so, the company held its forecast of adjusted earnings of at least $5.25 a share for the year.
Chief Executive Joseph Zubretsky called the dual-eligible business “core to our Medicare strategy” on the October call. Molina expects a pretax margin of 1.4% in duals this year, worth about $1.25 a share. Chief Financial Officer Mark Keim said the duals medical care ratio is about 92% when MAPD is stripped out.
Keim put the full Medicare segment at a 92.2% medical care ratio for 2026, contributing about 25 cents a share. His fourth-quarter estimate was higher, at 94.7%, which would mean the segment earns less in the final three months.
Growth in 2027, management said, depends on state program changes in Ohio, Texas and California. Keim did not detail those changes on the call. The release does not give a 2027 Medicare membership target.
Molina’s overall results show why Medicare is being trimmed to its core. Companywide adjusted earnings were 89 cents a share in the third quarter, down from $1.84, and the consolidated medical care ratio rose to 92.9%. Zubretsky called the quarter a “challenging environment” but said the company is reaffirming its full-year guidance.
Who has to move, and by when
The Medicare enrollment window is short. Medicare.gov lists the open enrollment period as October 15 through December 7. During those weeks a person can join, drop or switch a Medicare Advantage plan, and coverage begins January 1. The plan must receive the request by December 7.
That makes today, October 25, the middle of the choice period for a member of an MAPD plan Molina is dropping. Molina has not published a list of affected counties or plan names in its earnings release, so the plan’s own notice and the member’s 2027 plan options on Medicare.gov are the places to find the specifics.
Medicare.gov says special enrollment periods also exist outside the fall window, for situations such as losing or changing current coverage or getting Medicaid. In exceptional situations, the site says, a person has two months to join or switch plans. A member should confirm which of those applies to a specific case with the plan or Medicare before the December 7 date passes.
Dual-eligible members, who have both Medicare and Medicaid, sit on the other side of the decision. Molina is saying that is the group it wants. For those members the company’s message is continuity, but the plan details that matter, such as drug coverage, doctor networks and any added benefits, still come in the annual notice of changes.
The membership drop of 40,000 from December to September also shows how fast a Medicare book can shrink even before an exit takes effect. A member who stays in a plan by default instead of comparing options takes on whatever the insurer has chosen for 2027, including a different network or a different drug list.
The open question for a Molina Medicare member is simple: does the 2027 plan still cover the same doctors and prescriptions at a cost that fits the household? For members who find it does not, the extra cost has to be covered from somewhere, and a number of programs outside Medicare exist for that purpose.
Is your Molina Medicare plan one of the ones leaving?
Molina is exiting its traditional Medicare Advantage prescription drug plan for 2027, and a member who drifts past December 7 without choosing a new plan has no new plan lined up for January 1. Medicare.gov says coverage changes made in open enrollment start that day, and the plan must receive the request by December 7.
Medicare plan changes are a household-cost question, which is the job The Benefits Checklist finishes. It scans 11 benefit programs retirees most often miss, including Medicare Savings Programs and Extra Help, with the 2026 income limits and a 50-state phone directory, so help with premiums and drug costs can be applied for beside a new plan.
Check 11 programs that cut Medicare premium and drug costs in the Benefits Checklist →
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
