About Molina Healthcare Coverage in Pembroke
Molina Healthcare operates 4 distinct plans in Pembroke, MA, with a combined in-network roster of 43 doctors across 16 medical specialties. Among the five largest insurers we track in Pembroke, Molina Healthcare ranks #5 by provider count, the leader is Medicare with 198 in-network doctors. Use this page to confirm a specific provider is in-network, understand which Molina Healthcare plans have the widest reach in Pembroke, and compare coverage against other major insurers before scheduling care.
Molina Healthcare sells SNP, HMO plan types in Pembroke. A PPO (Preferred Provider Organization) lets you see any provider without a referral; out-of-network care is covered but you pay a higher share. An HMO (Health Maintenance Organization) requires you to pick a primary-care doctor and get referrals for most specialist care, usually in exchange for lower premiums. An EPO (Exclusive Provider Organization) is in-network only, like an HMO, but skips the referral requirement. A POS (Point of Service) plan blends HMO-style in-network with PPO-style out-of-network options. Your plan name is on your member ID card.
Molina Healthcare is a Medicare Advantage carrier in Pembroke with 3 plans available to seniors, listed below with star ratings and premiums. Molina Healthcare does not currently sell ACA marketplace plans in MA; commercial coverage shown above comes through employer groups.
Data is sourced from the federally-mandated CMS Transparency in Coverage filings that every insurer must publish monthly. Medicare Advantage plans come from the CMS MA Landscape File. Last refreshed May 29, 2026. Networks change between filings, so even when a doctor appears here we recommend calling their office with your member ID to confirm current network status before your visit.
Plan Type Mix in Pembroke
Molina Healthcare organizes its Pembroke network into several plan types, each with different rules about which doctors you can see and what referrals you need. The bars below show the unique-provider share of the 43-doctor network that offers plans of each type.
A high PPO share means most Molina Healthcare doctors in Pembroke accept the insurer’s broader preferred-provider plans. these give you maximum choice and don’t require referrals to specialists. A high HMO share signals a tighter gatekeeper model: lower premiums but you usually need your primary-care doctor to refer you before a specialist will bill. EPO and POS bars sit between those two on both flexibility and cost.
Because individual doctors typically participate in multiple Molina Healthcare plan types at once, these percentages don’t sum to 100%. the same provider can appear as both PPO and OAP coverage. What the chart tells you is which plan categories have meaningful depth in Pembroke.
Percentages don’t sum to 100% because most doctors participate in several plan types simultaneously.
Molina Healthcare Plans in Pembroke
Molina Healthcare contracts with doctors at the network level in Pembroke. Each network below is a contract; your specific plan (printed on your member ID) maps to one of them.
Senior Whole Health (HMO D-SNP)
SNP
42
Molina One Care
42
Molina Medicare Choice Care (HMO)
HMO
1
Molina Medicare Complete Care (HMO D-SNP)
SNP
1
Molina Healthcare Medicare Advantage Plans in Pembroke
3 Molina Healthcare Medicare Advantage plans available to seniors in Pembroke. Each plan combines Medicare Parts A, B and usually D (prescription drugs) into one product, with star ratings and monthly premiums shown.
Star ratings (1-5) reflect overall plan quality measured by CMS. a 4-star plan generally indicates above-average member experience and care coordination. Premiums shown are the monthly cost on top of the standard Medicare Part B premium.
Source: CMS Medicare Advantage Landscape File. Star ratings reflect overall plan performance per CMS quality measures. Premiums shown are monthly Part C+D consolidated.
Top Specialties Accepting Molina Healthcare
Molina Healthcare’s Pembroke network spans 16 distinct medical specialties. The mix reflects where the insurer has negotiated the deepest physician contracts. primary-care specialties and behavioral health tend to dominate, with surgical and sub-specialty networks typically narrower.
Click any specialty below to see a filtered list of just those in-network providers in Pembroke, including ratings, locations, years of experience, and contact information. For specialties with fewer than 10 in-network providers, you’ll likely want to check nearby cities too. the section further down on this page has your geographic options.
Physician Experience in Molina Healthcare’s Pembroke Network
Years since medical school graduation is a reasonable proxy for experience, though it doesn’t capture fellowship training, subspecialty certifications, or years spent in specific clinical settings. For Molina Healthcare’s Pembroke network the breakdown below gives a quick sense of whether you’re picking from a predominantly early-career roster or one weighted toward veteran practitioners.
A network heavy on early-career doctors (0–5 years) often means lower wait times for new patients and exposure to the latest training, while veteran providers (30+ years) typically bring deeper pattern recognition for unusual presentations. A balanced distribution. roughly one-quarter in each bucket. is a healthy signal that the insurer has depth at every career stage, not just new graduates filling out its directory.
Telehealth Coverage in Pembroke
5 of 43 Molina Healthcare in-network providers (12%) offer telehealth visits in Pembroke. Video appointments are typically covered for follow-ups, medication refills and adjustments, mental-health sessions, dermatology triage, and low-acuity primary care.
Availability and reimbursement still vary by state regulation and specific plan. Psychiatry, behavioral-health, and primary-care telehealth is near-universal at this point; procedural specialties (cardiology, orthopedics) typically offer video visits for pre-op consults and post-op follow-up but not initial diagnostic visits. Call the office with your Molina Healthcare member ID to confirm your plan covers the visit type you need.
Top specialties offering telehealth in Pembroke
Top Hospitals Serving Molina Healthcare Patients in Pembroke
Hospitals with the most Molina Healthcare-network physicians practicing there. Large affiliation counts indicate that Molina Healthcare has a durable relationship with the facility, which typically means smoother prior-authorizations for admissions, lab work, and follow-up care coordinated under one roof.
Hospital coverage is a separate contract from physician coverage. your Molina Healthcare plan may cover a doctor who admits at Hospital X but classify the hospital itself as out-of-network, leaving you with a surprise facility bill. Before scheduling anything inpatient or procedural, call both the doctor’s office and the hospital billing line with your member ID to confirm both sides are in-network for the specific plan you hold.
South Shore Hospital
South Weymouth, MA
Brigham And Women's Hospital
Boston, MA
Beth Israel Deaconess Hospital Plymouth
Plymouth, MA
Brigham And Women Faulkner Hospital
Jamaica Plain, MA
Beth Israel Deaconess Medical Center
Boston, MA
Massachusetts General Hospital
Boston, MA
Coverage Compared in Pembroke
Side-by-side provider counts for the five largest commercial and government insurers tracked in Pembroke. These numbers show raw network breadth. they don’t adjust for quality, specialty mix, or your specific plan’s tier structure, but they’re a useful first filter when choosing a carrier at open enrollment.
If Molina Healthcare’s provider count looks limited for your needs, the alternatives below may fit better. Click any row to open that insurer’s Pembroke provider list with the same filters, plan breakdown, and hospital affiliations that you’re seeing here.
Nearby Cities with Molina Healthcare Coverage
Cities closest to Pembroke where Molina Healthcare has an in-network provider base of meaningful size. Useful if you’re willing to drive a short distance for a hard-to-find specialist, have two offices to choose between, or are planning a move inside the region.
The mileage figures are straight-line distances computed from average practice-address coordinates, not drive-time. Counts reflect each nearby city’s Molina Healthcare network size. a small count doesn’t mean no coverage, just that your in-Pembroke options are likely more plentiful.
Frequently Asked Questions
Common questions about Molina Healthcare coverage in Pembroke
How do I find an Molina Healthcare in-network doctor in Pembroke, MA?
Molina Healthcare has 43 in-network providers across 16 medical specialties in Pembroke. This list is compiled from federally-mandated CMS Transparency in Coverage filings, last verified May 29, 2026. Filter by specialty, plan type, gender, telehealth or experience above to narrow your search, then click any provider for full credentials and contact details. Always confirm coverage with your specific plan before scheduling.
What Molina Healthcare plan types are available in Pembroke?
Molina Healthcare sells 2 distinct plan types in Pembroke: SNP (43 doctors), HMO (1 doctors). PPO plans give you the broadest provider choice without referrals; HMO plans require a primary-care referral but typically have lower premiums; EPO plans skip the referral but stay in-network only; POS plans blend HMO in-network rules with PPO out-of-network options. Choose by reading what's printed on your member ID card and matching it to one of the rows in the Plans section above.
Does Molina Healthcare offer Medicare Advantage in Pembroke?
Yes. Molina Healthcare offers 3 Medicare Advantage plans in Pembroke for 2026, with plan types including HMO D-SNP. The average CMS star rating across these plans is 4.5 of 5. Medicare Advantage (Part C) bundles Parts A and B with usually Part D prescription drug coverage, often adding dental, vision, and wellness benefits. Enrollment is open during the annual election period each fall.
What's the highest-rated Molina Healthcare Medicare Advantage plan in Pembroke?
Senior Whole Health SCO (HMO D-SNP) (HMO D-SNP) holds Molina Healthcare's top CMS star rating in Pembroke at 4.5 of 5, with a $0 monthly premium. Star ratings reflect overall plan quality based on member experience, customer service, drug pricing, and clinical care measures. Plans rated 4 or higher generally indicate above-average performance.
Are there $0 premium Molina Healthcare Medicare Advantage plans in Pembroke?
Yes. 1 of Molina Healthcare's 3 Medicare Advantage plans in Pembroke carry a $0 monthly premium for 2026. Note that $0 premium plans still require you to pay the standard Medicare Part B premium each month, plus copays and deductibles when you use care. Compare each plan's MOOP (maximum out-of-pocket) limit to understand worst-case annual cost.
Which hospitals in Pembroke accept Molina Healthcare?
Hospitals where Molina Healthcare doctors most commonly practice in Pembroke include SOUTH SHORE HOSPITAL, BRIGHAM AND WOMEN'S HOSPITAL, BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, BRIGHAM AND WOMEN FAULKNER HOSPITAL. This is inferred from physician affiliations rather than direct insurer-hospital contracts, so confirm hospital network status separately with both your Molina Healthcare plan and the hospital's billing department before scheduling any inpatient or surgical procedure. Even when a doctor is in-network, the hospital where they admit may not be.
Which medical specialties have the most Molina Healthcare providers in Pembroke?
Molina Healthcare's Pembroke network is largest in Physician Assistant (9), Nurse Practitioner (9), Cardiovascular Disease (cardiology) (5). Primary care, behavioral health, and physical therapy tend to dominate insurer networks because high patient volumes drive deeper provider contracts. Surgical sub-specialties typically have narrower networks. Click any specialty in the section above to see a filtered list of those in-network providers.
How does Molina Healthcare compare to other insurers in Pembroke?
Molina Healthcare ranks #5 of 6 major insurers tracked in Pembroke by provider count, with 43 doctors. Medicare leads at 198 providers. Larger network size means more provider choice but doesn't guarantee that your specific doctor is in-network with any insurer. The Coverage Compared section above shows side-by-side counts for the top five carriers in Pembroke.
How do I verify a doctor is in-network with Molina Healthcare?
Three steps: first match the doctor's name against this list, second call the provider's office with your member ID to confirm they currently accept your specific Molina Healthcare plan, and third check Molina Healthcare's own member portal for the most authoritative real-time status. Networks change between monthly federal filings; our data was last refreshed May 29, 2026.
What if my doctor isn't listed here?
This list reflects Molina Healthcare's submitted network data as of the last federal filing on May 29, 2026. Doctors join and leave networks between filings, so a current in-network provider may be missing if they joined recently. Call the doctor's office to ask whether they currently accept Molina Healthcare, then check Molina Healthcare's own member portal for confirmation.
When was this Molina Healthcare data last updated?
The Molina Healthcare Pembroke provider list was last refreshed May 29, 2026. Doctor and network data come from the federally-mandated CMS Transparency in Coverage filings that every insurer must publish monthly. Medicare Advantage plans come from the CMS MA Landscape File. Refresh cadence: monthly for provider data, annually for marketplace and Medicare plans.
Related healthcare resources
Patient resources for Pembroke Molina Healthcare members.
Common health topics
Common medications
Common procedure costs
Data freshness
Last verified May 29, 2026 · Source: CMS Transparency in Coverage federal filings · Refresh cadence: monthly