Molina Healthcare Alcohol And Drug Treatment Coverage
Dr. C. David Molina founded Molina Healthcare in 1980 to bring high-quality, affordable healthcare to low-income families in Southern California.1 Today, Molina Healthcare is a Fortune 500 company that provides healthcare services through Medicaid, Medicare, and the health insurance marketplace in the United States. Serving nearly 2.3 million members, Molina Health is available in the following states:1
- New Mexico
- New York
- South Carolina
If Molina Health is your health insurance provider and you’re looking for drug and alcohol addiction treatment, understanding what is covered by your insurance plan can offer peace of mind while you focus on your recovery and sobriety. It is important to verify your insurance and confirm what’s covered before you enter drug and alcohol addiction treatment. You can learn more about your specific plan in a number of ways:
- Log in to Molina’s website and member portal to read through the details of your plan.
- Call the number on the back of your insurance card. This connects you with a Molina customer service agent who will walk through your plan with you and answer any questions you have about what parts of addiction treatment will be covered.
- Check directly with the treatment center. If you know what rehab treatment center you want to attend, you can ask them to check your insurance benefits for you while you’re on the phone.
What Will Molina Healthcare Insurance Cover?
The Mental Health Parity and Addiction Equity Act of 2008 requires all insurance companies that offer plans through the marketplace or state exchange to provide mental health care and addiction treatment coverage.2 This ensures that your Molina insurance plan offers coverage for drug and alcohol addiction treatment.
Different Molina plans offer varying degrees of coverage. For example, some plans may require a higher deductible or higher copays than other plans. While every Molina plan offers some coverage for addiction treatment, the exact treatments and services covered vary. Understanding what your specific plan covers is important before entering treatment. This way you know what out-of-pocket expenses you can expect and come up with a plan on how you will cover those costs before you begin treatment.
Most Molina plans will require pre-authorization before providing coverage. This means you will need to see your doctor or a counselor and discuss your substance abuse and addiction to prove that treatment is required. Once this authorization is provided, the insurance company will work with the rehab center to discuss payment for your treatment.
Addiction services that Molina insurance plans will likely cover include:3
- Screening to learn more about your alcohol and drug addiction and determine the level of care/treatment required.
- Medical detoxification.
- Treatment for mental health disorders.
- Inpatient/outpatient rehab.
What Types of Addiction Treatment Does Molina Healthcare Cover?
Many Molina plans provide full or partial coverage for intensive addiction treatment services. These may include:4
- Inpatient rehab programs. This type of intensive and structured treatment requires you to live at the rehab center for a certain number of days/weeks. You will receive daily therapy both individually and in group settings. You may also receive medication-assisted treatment. Staff is at the treatment centers 24/7, and support is provided around the clock to help you focus on your sobriety and recovery. You will likely need to provide pre-authorization for inpatient treatment before your Molina insurance coverage kicks in. Some rehab centers do not accept Molina insurance, so it’s important to ensure ahead of time that the rehab you are considering accepts your insurance.
- Outpatient treatment programs. Many people attend outpatient treatment programs before inpatient treatment. Less intensive than inpatient, outpatient allows you to live at home and maintain your day-to-day life while also completing treatment.
- Partial hospitalization programs (PHPs). Partial hospitalization programs allow you to live at home while you get treatment, and you will spend your days at the treatment facility. This is an option for those who know they can stay sober during the evenings they are not at the treatment center and commit to attending the treatment center every day.
- Intensive outpatient (IOP) treatment. Intensive outpatient treatment generally involves attending treatment programs 3-5 evenings a week. IOP programs allow you to attend work during the day, sleep at home, and attend treatment and counseling sessions in the evenings.
Call Molina insurance using the number on the back of your insurance card to discuss the next steps before selecting a treatment program. They will advise you on how to get preauthorization to begin treatment and will work with you to help you decide which option is best for you.
Does Molina Healthcare Cover Mental Health Inpatient Treatment?
Yes, Molina Insurance covers mental health care. All outpatient mental health services are a benefit covered by Molina. These services include:5
- Individual and group mental health evaluation and psychotherapy.
- Psychological testing.
- Outpatient drugs and supplements.
- Psychiatric consultation.
- Alcohol misuse screening services.
It is common for people with substance use disorder (drug and alcohol addiction) to have mental health conditions such as anxiety, depression, and PTSD. This is known as “dual diagnosis” or co-occurring disorders. According to the 2016 National Survey on Drug Use and Health, more than 8 million adults aged 18 or older with substance use disorder also had a co-occurring disorder.6
Treating mental health conditions at the same time as drug and alcohol addiction is best for optimal treatment outcomes.7In most cases, each disorder impacts the other, and so it is best to look for a rehab facility that offers treatment for mental health conditions along with addiction treatment.
Under the Affordable Care Act, substance use disorder is listed as one of the 10 elements of essential health benefits that insurers must provide.8 Like all American insurance providers, Molina must cover mental health care and treatment. While their insurance plans cover some degree of mental health treatment while you are in rehab, the amount of coverage will depend on your specific policy.
How Long Does Molina Insurance Cover Rehab?
Molina insurance offers many different types of health insurance policies and plans. The length of time for treatment coverage depends on your specific plan.
Generally, longer treatment times are associated with better treatment outcomes (e.g., lower risk of relapse, long-term sobriety). According to a recent study, 3-6 months of treatment, together with structured continuing care (outpatient counseling and treatment), is associated with better outcomes for people living with substance use disorders.9
You can look up your Molina insurance plan information online to learn how many days of treatment will covered in a calendar year. Or call the number on the back of your insurance card to learn more about your specific plan’s drug and alcohol rehab coverage.
What if My Molina Policy Does Not Cover Rehab?
As a Molina Health member, at least some of your treatment should be covered by your specific plan. Even if your policy won’t cover all of your rehab expenses, it’s imperative to get into treatment as soon as you’re ready. Starting and completing treatment saves lives, so don’t let your insurance coverage prevent you from getting the treatment you need to live a healthy, sober life.
Many drug and alcohol treatment centers work with Molina to provide coverage for drug and alcohol addiction. There are several ways you can pay for your out-of-pocket treatment costs, including:
- Payment plans offered by the rehab center.
- Scholarships and grants from the government and/or rehab centers.
- Crowdfunding (asking family and friends for support).
- Entrepreneurship—selling goods you’ve made or services you can perform before entering treatment.
Talk with an admissions navigator at the rehab center(s) you are considering and discuss your payment options. They can help verify your insurance to determine what your policy will cover and help you formulate a plan to cover your out-of-pocket costs for treatment.
Molina In-Network vs. Out of Network Rehab Centers
In-network drug and alcohol rehab centers have an agreement with Molina to offer treatment at a set payment rate that is typically lower than out-of-network rehab facilities. Out-of-network facilities do not have an agreement with Molina, which means that you may be responsible for paying more or all of the costs of treatment yourself.
The difference in cost when selecting in-network vs out-of-network can be tremendous. Choosing a treatment facility in Molina’s network can decrease your out-of-pocket costs and provide much-needed peace of mind so you can focus on your recovery and sobriety.
There are some cases where Molina may cover out-of-network treatment facilities—if you live in an area where you cannot access treatment at an in-network facility, for example, or if you belong to a certain population (e.g., veteran) and need a treatment plan specializing in that community’s needs. However, it is likely to require a lot of work on your part to get some coverage for an out-of-network provider.
Whether you choose an in-network or out-of-network provider, Molina will require pre-authorization to prove that treatment is medically necessary before your insurance coverage kicks in.
How To Use Molina Healthcare Plan For Addiction Treatment?
Before you select a rehab facility for yourself or a family member, check your Molina insurance policy benefits to determine which costs will be covered and which will be out-of-pocket for you. Knowing what to expect ahead of time can help provide much-needed peace of mind while in treatment so you don’t have to worry about the financials and can instead focus on your recovery.
Call the number on the back of your insurance card to speak with a Molina customer service agent. Or, log in to your account on Molina’s website to learn the details of your policy, including copays and/or what deductible must be reached before coverage kicks in.
American Addiction Centers can verify your insurance coverage for you. Complete the form below to enter your information and see immediately if the center you are considering is in-network with Molina. Alternatively, you can call our helpline at and speak to an admissions specialist who can check your benefits while you’re on the phone.