Molina Gold 1 Plan
Health Insurance Carrier:
This is a Molina Marketplace plan. Marketplace plans include an annual physical and many preventative services for free, include prescription benefits, cover maternity, and mental health visits. They also cover preexisting conditions without a waiting period. Based on your household size, zip code and income; you may receive subsidies to pay for a portion of your premium. Molina is an EPO plan which means that you must use in-network doctors and hospitals, except for emergencies. Molina mainly has the Mountain Star hospitals, University of Utah hospitals and Primary Children's hospital included in their network. They have a very large network of doctors to choose from plus you do not need a referral to see a specialist.
Snapshot of benefits
This is a quick snapshot of the most popular copays, deductibles, and coinsurance that you would be responsible for on this plan. To learn what each of these terms mean, please visit our terms and definitions page. Copays and coinsurance listed are amounts that you would pay before deductible unless specified otherwise. This is not a full list of services included on the plan. This snapshot is not guaranteed to be accurate. To verify plan benefits or for full details please see the full summary of benefits or or get a complete terms of coverage on the health plan carrier's website.
Maximum Out of Pocket
Primary Care Visit
Specialty Care Visit
Mental Health Visit
Virtual Visits / Telehealth
Urgent Care Visit
Ground Ambulance Transport
Preferred Generic Rx
Children's Eye Exam
Children's Dental Check Up
20% after deductible
20% after deductible
Frequently Asked Questions
How do I get my ID card?
You'll receive your ID cards in the mail about two weeks after you sign up for this plan. Be on the lookout in your mail box for an envelope with the company's logo on it. You can also download and get a digital copy of your ID card in the member portal. Visit the website below or download the member portal app on your phone. If you need to see a provider before your ID cards arrive in the mail, your doctor's office will be able to look up your plan with your name and birthday. You can also call or text our office and we will help get you the right information.
Is your doctor and hospital in network?
Here you can search on the provider's website to see if your preferred doctor and hosptial are in network. Have questions or need help searching? Please feel free to reach out to your agent. We're happy to help with this for free.
Is your prescription covered?
You can research to see if your prescription is covered. If you are diabetic and taking an insulin, the search results will show that your insulin is covered, but sometimes it does not show the correct copay or cost sharing amount on the link. Please reach out to one of our local agents to verify your prescription costs.
I heard that I can get my inhaler, insulin and Dex Com pump for free now, is that true?
Yes, some health plans on the Marketplace include low cost to zero cost for your inhalers; insulins; continuous glucose meter; like the Dexcom, FreeStyle and OneTouch; diabetic supplies; and diabetes-related equipment. This is not a complete list of low cost benefits and if you want to learn more or see if you qualify for one of these benefits, please contact one of our agents. We'd love to help you! Plus our help is always free.
Currently Enrolled with this plan? Log into your portal.
Below is the link to log into your client portal. Most companies have an app you can also download onto your phone. The best place to view information about your health insurance is through the member portal. The member portal gives you easy access to your plan details, claims information, deductible and out-of-pocket details, ID cards, and more. You can update your payment information in the member portal, too. Simply set up an account and login by clicking the member portal link below. If you have any issues logging in, just give us a call and we can help.
Premium payments is the monthly amount you pay for your health insurance plan. It is usually due on the first of each month. The initial premium, or binder payment, needs to be made before your plan starts. Be sure to watch your account to make sure the premium has been debited. Most carriers accept bank accounts, debit cards and credit cards as payment. If you need to update your account, you can log into your portal or call our office for help.
Why does Healtcare.gov keep emailing, calling and sending so many letters? How do I get it to stop?
As you may have already noticed, you probably received emails, phone calls or letters from the Marketplace or healthcare.gov shortly after you enrolled in your plan. They do that because you may need to submit further documentation to verify your income, citizenship or immigration status. As your agent, we take care of this for you. We can submit all the required documentation for you and will contact you if anything further is needed. If we are your agent and you do get any further notices or calls, let them know your agent is handling it, and hang up. PLEASE DO NOT MAKE ANY CHANGES OR SUBMIT ANY DOCUMENTS directly to healthcare.gov as this may adversely affect your coverage. Feel free to securely send us your documents with the link below. Remember having an agent is free!
I've been told I don't qualify for plans by other agents and healthcare.gov. How can Utah Avenue Insurance help when no one else can?
At Utah Avenue Insurance, you not only get a well trained agent on your side, you get our entire staff to ensure that you get all the benefits you're entitled to. We have daily trainings on plans, benefits, rules and regulations to stay on top of all the many changes to health insurance so that you don't have to. We study the fine print of many of the Marketplace rules so that you have a plan that works at an affordable price. Our staff helps us ensure that all the needed documents and forms are submitted and approved. We appreciate that you trust us to help you with your health insurance.
Deductible? Copays? Coinsurance? What does it mean?
Learn the basic terms about health insurance to better understand your plan. Don't worry, most people don't know what these terms mean and how they apply to your plan. That's why we're here. Please contact us if we missed any terms or if you'd rather talk to us instead of read.
Learn more about this plan and if you qualify for lower monthly premiums
Find out if you qualify for subsidies (lower monthly premiums). Most families do qualify for lower premiums. Get a quote for you and your family or book an appointment with a local Utah health insurance agent. You can book a phone, virtual or office appointment.
Schedule a consultation with a local Utah health insurance agent
We're happy to meet with your in-person or over the phone to help you with your health insurance needs. We can help you with health insurance on or off the marketplace, Medicare Advantage & supplements, dental insurance, vision insurance, life insurance or accident plans. Thank you for letting us be your advocate. Best part, is our help is always free!