Molina Healthcare Alcohol And Drug Treatment Insurance Coverage

Molina Healthcare is a California-based insurance company that provides government-assisted Medicaid and Medicare health plans in a number of United States areas. Molina Healthcare’s affiliated insurance plans may provide coverage to help pay for rehab programs, outpatient treatment, and more.

Molina Healthcare insurance company provides Medicare options across the country and Medicaid plans in 13 states and Puerto Rico. They serve over 3.3 million members as of 2019.

Because Molina Healthcare provides a wide variety of Medicaid and Medicare insurance plan options, its members may have access to abundant benefit services.

These benefits may help cover the costs of drug and alcohol rehabilitation, and Molina Healthcare plans may be accepted through a number of Massachusetts drug rehab centers. Spring Hill Recovery Center works with many types of health insurance plans.

Molina Healthcare Insurance Coverage For Massachusetts Drug And Alcohol Rehab

Out-of-pocket and covered expenses for drug and alcohol rehab varies by the type of plan you have. In addition to Medicaid, Molina Healthcare has options available in the Health Insurance Marketplace.

These healthcare plans are in four main tiers based on how much medical care you’re anticipating to receive. Health Insurance Marketplace plans are available for enrollment at a certain time each year, with some exceptions based on life-changing circumstances.

The tiers include:

  • Bronze—Usually offers lower premiums and covers 60 percent of expenses.
  • Silver—Provides modest premiums and covers 70 percent of medical costs.
  • Gold—Comes with higher premiums but lower out of pocket costs. Covers 80 percent of medical expenses.
  • Platinum—Offers the highest amount of coverage at 90 percent. Available in select states only.

Deductible amounts in your plan may affect the overall cost you have to pay for drug rehab. For example, you may have to pay the deductible before coverage is applied for a drug rehab program.

It’s a good idea to review your deductible amount and covered benefits in your Molina healthcare plan before visiting an addiction center. Where you go for drug and alcohol treatment may also affect coverage if the treatment facility is in-network or out-of-network for your plan.

How Molina Healthcare Insurance Pays For Addiction Treatment

Using an insurance plan to pay for addiction treatment is far less expensive than paying the full amount by yourself. Several factors can affect the overall cost of addiction treatment with health insurance. Here’s what to look for to help you plan for the price for your treatment.

Is Molina Healthcare Insurance In-Network With Massachusetts Drug Rehab Centers?

Molina Healthcare provides many Medicare and Medicaid assisted health plans. Many health insurance plans fall into two categories: PPO and HMO plans.

HMO and PPO plans operate from within a network of preferred treatment providers. When using your insurance coverage at a substance abuse treatment provider that is in-network, you usually enjoy a higher amount of savings.

You’re also more likely to receive full or partial coverage for inpatient treatment and other rehab programs when you stay in-network with your healthcare plan.

Reduced coverage is available for out-of-network providers in most Molina Healthcare affiliated plans. This means that Molina members may be eligible for drug and alcohol rehab coverage even if the provider of choice is not part of their plan’s network.

Out-Of-Pocket Costs For Drug Rehab Programs

What you’ll pay outside of insurance could include a few different treatment expenses, such as paying your insurance deductible, covering any copayments, and planning for costs not covered by your health insurance policy.

It’s important to understand your plan’s deductible and copayments so you know how much is needed to pay upfront and what you can expect to pay throughout treatment.

If you need help paying treatment costs not covered by Molina Medicaid and Medicare plans, many treatment facilities extend payment plan options to offset your cost.

Some rehab centers offer scholarships that may cover addiction treatment costs. Other grants, scholarship funds, and sliding fee scales may also help patients and their families pay drug and alcohol rehab programs.

Finding A Massachusetts Rehab Center That Accepts Molina Healthcare

Medicare and Medicaid affiliated health plans like those from Molina Healthcare are widely accepted by many rehab centers in the United States.

To find out which treatment centers accept your insurance, talk with a Molina Healthcare insurance agent about your treatment options. It’s important to be informed about what’s covered in your plan to avoid any unwanted or surprise costs. You may also speak with a Spring Hill Recovery Center treatment representative to learn more information.

Does Molina Healthcare Cover Inpatient Rehab?

Inpatient treatment, also called residential treatment, coverage may vary with Molina Healthcare affiliated plans. Inpatient programs typically last from two weeks to 30 days or more.

How long your inpatient drug rehab program will be covered by Molina may depend on certain factors, such as whether you have a medical necessity for treatment.

Are Alcohol And Drug Detox Programs Covered By Molina Healthcare?

Detoxification is the first critical step in treatment for substance use disorders that include a chemical dependency on drugs or alcohol. Most insurance companies like Molina Healthcare provide coverage for drug and alcohol detox since this treatment service can be important, and even life-saving, for addicted individuals.

Does Molina Healthcare Cover Outpatient Drug Rehab?

Outpatient treatment is a flexible treatment option for recovering individuals that does not require an overnight stay at a drug rehab facility. Outpatient services for substance abuse are covered in many Medicare and Medicaid affiliated plans like Molina Healthcare. Individual plans may differ in coverage amount, so it’s important to understand anticipated costs ahead of time.

Are Partial Hospitalization Programs Covered Through Molina Healthcare?

Many Molina Healthcare policies cover partial hospitalization programs. Partial hospitalization treatment, or day treatment, may be worthwhile for those who do not need to detox or who have completed residential treatment and are ready for the next phase in the continuum of care.

Are Intensive Outpatient Programs Covered By Molina Healthcare?

A Medicare supplemental plan such as Molina may also cover intensive outpatient programs. These programs are similar to partial hospitalization programs in level of flexibility, therapy, and treatments. Coverage level for IOPs may differ among Molina insurance plans.

Does Molina Cover Medication-Assisted Treatment?

Molina Healthcare and many other supplemental health plans may cover medication-assisted treatment programs, which work to safely treat those who are in withdrawal from opioids, alcohol, or other addictive substances.

Does Molina Healthcare Cover Methadone Costs?

Methadone is a medication often used to treat those with opioid use disorders. Methadone maintenance therapy is one of the oldest forms of medication-assisted treatment and can be covered by Molina Healthcare plans.

Will Massachusetts Molina Healthcare Cover Suboxone Costs?

Suboxone is another medication used in MAT programs, which is often paired with behavioral therapy, counseling, and other treatments as part of a comprehensive addiction treatment plan.

Suboxone, or Suboxone therapy, may be covered by Molina insurance policies if a person’s need for medication-assisted treatment is deemed necessary through a clinical evaluation.

Does Molina Healthcare Cover The Cost Of Sober Living?

Sober living homes help rehab program graduates explore their independence as they continue with other, less intensive forms of outpatient treatment.

In sober living facilities (also called transitional facilities or halfway houses), recovering individuals can receive support, counseling, therapy, employment assistance, and more. Sober living home costs may be covered by Molina depending on your plan and the state you live in.

Does Molina Cover Aftercare Program Costs?

Aftercare, or continuing care, can be crucial to long-term addiction recovery, which is why these programs are so often covered by insurance companies like Molina. However, program formats can differ greatly, so it’s important to understand exactly which aftercare recovery programs are covered by your Molina policy before enrolling in one.

Verifying Your Molina Healthcare Insurance For Substance Abuse Treatment

Before you or your loved one set your heart on a rehab facility, make sure that the treatment center accepts your health insurance plan. This will make the process of admissions easier, and save you money on the overall costs associated with addiction treatment.

Taking the first step toward recovery is taxing enough—don’t let the stress of wondering how you’ll pay for treatment talk you out of this important decision. Spring Hill Recovery Center can help with this process.

To learn more about your addiction treatment options in Massachusetts or greater New England, or for help with determining what’s covered by your insurance plan, contact us today.

  1. Molina Healthcare - Our Story https://www.molinahealthcare.com/members/common/en-us/abtmolina/whymolina/story.aspx
  2. National Institute on Drug Abuse (NIDA)—Types of Treatment Programs https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states/types-treatment-programs
  3. Substance Abuse and Mental Health Services Administration (SAMHSA)—Medication-Assisted Treatment (MAT) https://www.samhsa.gov/medication-assisted-treatment

Written by Spring Hill Recovery Editorial Team

© 2024 Spring Hill Recovery | All Rights Reserved

* This page does not provide medical advice.

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