Drug & Alcohol Rehab Covered by Molina Insurance
Molina Healthcare operates in 11 states, including Texas, and has provided coverage to more than 4.6 million members.1,2 This article will help you understand your options for using Molina healthcare to cover rehab and how to check your benefits.
Does Molina Insurance Cover Addiction Treatment?
Yes. Molina marketplace healthcare plans cover addiction treatment. The Affordable Care Act enacted in 2010 included the following in their list of essential health benefits that all marketplace health insurance plans must cover:3
- Substance use disorder services.
- Mental health services.
- Behavioral health services.
Molina Healthcare has many plans, and the coverage can vary greatly from plan to plan. The amount of coverage your specific plan offers for substance use disorder treatment will depend on the plan you hold.
Molina marketplace offers more than 25 different plans in Texas alone. If you have one of these plans, you may be eligible to receive treatment at Greenhouse. We’ll help you verify your benefits in just minutes with our .
Cost of Substance Abuse Treatment with Molina Insurance
The cost of rehab under your Molina plan will depends on several factors, including your plan’s:2,4
- Deductible: The amount you must pay in a plan year before your insurance begins to pay for covered services.
- Copay: A fixed amount for a covered service that you pay (after your deductible has been met).
- Coinsurance: A percentage of the cost of a covered service (such as a stay at an inpatient facility stay) for which you are responsible.
If you have your summary of benefits given to you by your insurance company, you can begin to understand how Molina will calculate your treatment costs according to your plan. You can also reach out to treatment providers who can help you to understand the costs and what your insurance will cover.
The costs your insurance won’t cover are called your out-of-pocket costs. The best way to keep out-of-pocket costs to a minimum is to attend a treatment program that is in Molina’s network.
Which Types of Drug & Alcohol Rehab Does Molina Cover?
Molina offers numerous plans in which what is covered and to what extent will differ. Treatment covered by your Molina plan may include:
- Medical detoxification (withdrawal management): Medical interventions used to manage acute substance withdrawal.
- Inpatient rehab: Live-in intensive treatment where therapy, drug education, and healthy structure are emphasized.
- Outpatient treatment (e.g., partial hospitalization, intensive outpatient programs, or regular outpatient office visits): Treatment options that allow the patient to attend treatment while continuing to live at home.
- Telehealth treatment: Sessions with a treatment provider conducted online or by phone.
The level of care that Molina will cover will be determined by what they deem “medically necessary.” Services that meet the definition of medically necessary are:5
- In accordance with accepted medical standards.
- Appropriate for the treatment of the patient’s illness/injury/disease.
- Not primarily for the convenience of the patient or provider.
- Not more expensive than other services expect to produce equivalent outcomes.
When you wish to use your Molina insurance for rehab, remember that preauthorization may be required. This means that Molina must approve the service and deem it medically necessary prior to you beginning treatment, or they may deny coverage.6,7 At Greenhouse Treatment Center, we can help you obtain preauthorization when we work with you to get you admitted into treatment.
How to Use Molina Insurance to Pay for Rehab
Using your Molina healthcare to pay for rehab starts with finding an in-network treatment provider. Molina provides an online directory for you to search in-network providers in your area. If you have a plan that requires a referral for treatment, you may need to visit your primary care physician before attempting to get admitted into specialty care.
Greenhouse Treatment Center is in-network with Molina, and we can help you verify your Molina benefits with a simple online form. All you need to do is input some basic details (such as your name/contact information) and have your insurance card on-hand to provide your plan name and member number. Once you’ve submitted the form, you’ll receive email results in just minutes.
You can also request immediate help by calling us any time at . With Molina healthcare, you don’t have to put off getting the help you need. Today can be the day you take your first step toward a new life.