Molina Gold Value Plus with Adult Dental and Vision

Molina Healthcare · 2026 plan year

Gold
Ind. deductible
$2,250
Family deductible
$4,500
Ind. OOP max
$8,000
Family OOP max
$16,000

Compare with other Gold plans in SC

Side by side: deductibles, out-of-pocket limits and copays.

More Molina Healthcare plans in SC

Monthly premiums by age

Rating Area 1 — the lowest-priced of the 37 areas this plan covers. Premiums differ by area.

AgeIndividual
Under 15$317
21$415
30$471
40$530
50$741
60$1,126
64 and over$1,244

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$15.00

Specialist

BenefitIn-network
Specialist Visit$60.00

Hospital

BenefitIn-network
Emergency Room Services20.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)20.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services20.00% Coinsurance after deductible
Urgent Care Centers or Facilities$40.00

Pharmacy

BenefitIn-network
Generic Drugs$5.00
Non-Preferred Brand Drugs50.00% Coinsurance after deductible
Preferred Brand Drugs$75.00 Copay after deductible
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services20.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$15.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental20.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing$15.00
Bariatric SurgeryNot covered
Basic Dental Care - Adult50.00%
Basic Dental Care - ChildNot covered
Chemotherapy50.00% Coinsurance after deductible
Chiropractic Care20.00% Coinsurance after deductible
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care20.00% Coinsurance after deductible
Dental Check-Up for ChildrenNot covered
Diabetes EducationNo charge
Dialysis$60.00
Durable Medical Equipment20.00% Coinsurance after deductible
Emergency Transportation/Ambulance20.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Habilitation Services20.00% Coinsurance after deductible
Hearing AidsNot covered
Home Health Care Services20.00% Coinsurance after deductible
Hospice ServicesNo charge
Imaging (CT/PET Scans, MRIs)20.00% Coinsurance after deductible
Infertility TreatmentNot covered
Infusion Therapy20.00% Coinsurance after deductible
Inpatient Physician and Surgical Services20.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services$40.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - Adult50.00%
Major Dental Care - ChildNot covered
Nutritional CounselingNo charge
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$15.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)20.00% Coinsurance after deductible
Outpatient Rehabilitation Services20.00% Coinsurance after deductible
Prenatal and Postnatal CareNo charge
Private-Duty NursingNot covered
Prosthetic Devices20.00% Coinsurance after deductible
Radiation20.00% Coinsurance after deductible
Reconstructive Surgery20.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy20.00% Coinsurance after deductible
Rehabilitative Speech Therapy20.00% Coinsurance after deductible
Routine Dental Services (Adult)No charge
Routine Eye Exam (Adult)No charge
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility20.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services20.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$15.00
Transplant20.00% Coinsurance after deductible
Treatment for Temporomandibular Joint DisordersNot covered
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging20.00% Coinsurance after deductible

Plan rules

Service area

This plan covers 37 geographic areas.

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