Molina Healthcare Insurance Coverage for Addiction Treatment
Discover how Molina Healthcare covers drug rehab and addiction treatment. Learn about plan options, verification, and cost-saving strategies.
Molina Healthcare Insurance Coverage for Addiction Treatment
Discover how Molina Healthcare covers drug rehab and addiction treatment. Learn about plan options, verification, and cost-saving strategies.
Molina Healthcare was founded in 1980 as Molina Medical Center. They were a primary care clinic that served communities in southern California. The organization was not licensed as a health plan until 1994.
Today they are a Fortune 500 company that offers healthcare services to roughly 5.1 million members. They provide Medicaid plans, Medicare options, and plans in the Health Insurance Marketplace in multiple states.
Molina benefits may include prescription drugs, telehealth, vision care for children and adults, and case management for members needing extra help organizing and managing their healthcare concerns. Members also have access to a Nurse Advice Line 24/7, staffed by nurses who can answer your medical questions.
Does Molina Healthcare Insurance Cover Drug Rehab?
Molina Healthcare insurance plans are government sponsored or on the state Insurance Marketplace. As a result, all Molina plans will have some coverage for substance use and mental health. The 2010 Affordable Care Act requires that Marketplace and government sponsored plans cover 10 essential health benefits, which include addiction treatment and mental health.
Each policy will be different in terms of how much coverage is available and what the requirements are for treatment. For example, you might need preauthorization or be required to stay within your plan’s provider network.
Before admission into a drug addiction program, it is crucial to verify your insurance coverage. This ensures you are not surprised by healthcare bills.
What Plans Does Molina Healthcare Offer?
Molina Healthcare operates differently in different states based on state specific regulations. Molina Medicaid services are unique to each state since Medicaid is administered and managed by the state. For example, Molina Healthcare Washington includes services like crisis intervention, vision, dental, and nurse advice lines, and Molina Healthcare Ohio offers LGBTQ+ services, healthcare management, and behavioral health, to name a few.
Molina provider networks also vary significantly by state. The network depends on the availability of hospitals, primary care providers, and specialists in the area. Molina Healthcare Medicare plans help manage your standard Medicare benefits from the federal government and offer you additional benefits.
These include case management and complex case management using nurses who teach you more about your condition and work with your provider to ensure you get the care you need. Molina Guided Care is a specialized plan for people with serious illnesses or conditions to help reduce pain, stress, and confusion. Other benefits include non-emergency medical transportation and the Silver & Fit Fitness Program.
Molina also offers integrated Medicaid/Medicare managed plans for people who qualify for both programs. Molina has worked with these agencies for many years, so members are provided with the quality care they need to meet their unique needs.
Finally, to help serve those who don’t qualify for Medicaid, Molina offers low priced plans in various states’ Insurance Marketplace. The Marketplace allows you to get financial help paying your insurance premium every month so it’s a great option for those who don’t qualify for Medicaid but still need financial help.
Does Molina Cover Suboxone & Methadone (MAT)?
Medication-assisted treatment (MAT) can be appropriate to help you work through withdrawal symptoms when treatment starts. It can also help you manage opioid or alcohol cravings during your treatment process.
During medical detox you may receive FDA approved medications to help you safely navigate withdrawal symptoms and be as comfortable as possible. After detox, you may continue on MAT to manage cravings while you attend treatment. This can help you stay stable and avoid relapses while you lay a foundation for recovery.
MAT may be partially or fully covered by your Molina Healthcare plan.
What Types of Treatment Does Molina Healthcare Cover?
Your insurance plan will focus on paying for medically necessary care. You can work with your doctor to create a treatment plan that will help define what’s medically necessary for you.
There are a variety of treatment options. Many people start with medical detox where they are monitored and supported through the detox process to help manage withdrawal symptoms. After that, you may move into inpatient or residential treatment. Residential treatment allows you to fully focus on your recovery without outside distractions.
During outpatient care you live at home or in a sober living environment while you attend treatment several hours a week. The most intensive programs have full day treatment. There are also programs with around nine hours of treatment a week, and the lowest level is around one or two hours per week.
The exact treatment that’s covered will depend on your specific insurance plan so be sure to verify your coverage details before committing to a treatment program.
Does Molina Cover Other Mental Healthcare?
Molina plans cover mental health and behavioral health services. In many cases you must receive services from a provider that is in network with Molina to get coverage. You can call Molina or visit their Find a Provider page to connect with a specialist whose services are covered by your plan.
Molina Healthcare covers mental health and behavioral health services from licensed specialists. Covered services may include inpatient mental health stabilization, crisis support, therapy, and integrated treatment for those with co occurring mental health and substance use disorders.
How Do You Verify Coverage With Molina Healthcare?
There are two primary ways to verify your insurance coverage.
The first is to contact Molina directly. You can call the Molina Healthcare member services phone number. At this hotline, you can update your contact information with Molina and have your questions answered about coverage for treatment. You can also log in to your online Molina account to get information about coverage and in network providers.
Your second option is to work with the admissions people at your drug addiction facility of choice. They can verify your insurance coverage, answer your questions about treatment, and help estimate your out of pocket expenses. Some facilities offer financial assistance with sliding scale fees and payment plans to help you pay for expenses not covered by your insurance policy.
Addiction facilities may also help you find financial assistance in your local community, including scholarships and grants from local organizations and businesses. Many facilities also offer a free initial assessment to help determine if you qualify for treatment and offer some information about your treatment options.
How Much Does Rehab Cost Without Insurance?
The cost of rehab without insurance varies depending on several factors. These include the type of treatment you receive, the length of treatment, the geographical location of the facility, and the facility’s amenities. For example, inpatient rehab programs typically cost more than outpatient programs and the cost of medical detoxification is often more expensive as an inpatient than an outpatient.
However, that doesn’t mean you should delay treatment. There are many ways to pay for rehab. For example you can find programs with a sliding fee
scale based on income, or you can work out a payment plan with a center. Some treatment programs also have scholarships available. You can also borrow money from friends and family so you can reclaim your life and break free from substance use.
Does Addiction Treatment Need to Be in Network?
In most cases you will want to use Molina’s network of pre authorized providers. Using in network providers is the most cost effective way to access any healthcare services including addiction treatment. Providers participating in the Molina network have agreed to accept a negotiated reduction in fees for their services. Many Molina plans do not cover out of network addiction providers.
However, a few Molina plans may offer coverage for out of network mental health or addiction care. However you will likely have greater out of pocket costs in the form of higher copays and deductibles. This increase in cost can be very significant so be sure you’ve looked into what you would need to pay before you commit to a non network program.
Molina has a large network of professional service providers. Generally you should be able to find the treatment you need being offered in network and therefore save money. Always check you insurance plan to verify whether a specific treatment or a facility you are considering is covered by your insurance.
Calls to any general helpline will be answered or returned by one of the treatment providers listed, each of which is a verified paid advertiser.
By calling the helpline you agree to the terms of use. We do not receive any commission or fee that is dependent upon which treatment provider a caller chooses. There is no obligation to enter treatment.
Who Answers?
800-784-1361
Inpatient
Aftercare Support
12-Step
Sober Living Homes
Intervention Services
Partial Hospitalization Program
Medically Assisted Detox
Private Insurance
Self-Pay Options
Adult Program
Young Adult Program
LGBTQ Program
Outpatient
Intensive Outpatient
Financial Aid
Medicare
Medicaid
Sliding Scale Payment Assistance
Military Insurance
Military Program
24-Hour Clinical Care
