Answer: There is a wide array of addiction treatment services you may be able to get coverage for through Molina.
When it comes to substance abuse rehab, there are a number of treatment approaches, as addictions have varying needs and individuals may have unique goals/needs.
Keep reading to learn a bit about some common treatment approaches.
Many Molina plans will cover detox services, but you may be required to get prior authorization to receive coverage.
One treatment service you may get covered is medical detoxification or detox. This service helps to get rid of any addictive substances still in your body.
It’s important to make sure your body is substance-free so you can begin your treatment plan. In addition to monitoring your vitals and administering medications, detox services manage withdrawal symptoms and ensure you are detoxing safely.
Depending on your plan, Molina will often cover medication-assisted treatment (MAT), but Molina encourages providers to verify coverage prior to treatment.
MAT is the practice of using U.S. Food and Drug Administration (FDA)-approved medications to treat addiction, alongside therapy and counseling.
There are three main MAT medications: buprenorphine, methadone, and suboxone. MAT helps manage withdrawal symptoms, reduce cravings, and reduce the risk of relapse. It is used in combination with other treatment services.
Many Molina policyholders may be able to get inpatient treatment partially or fully covered. Individuals must meet medical necessity, receive prior authorization, and choose an in-network provider.
Inpatient treatment is a very intensive treatment option, offering the highest level of care. People with more severe addictions may benefit from inpatient treatment as it is very regimented and provides 24/7 care.
People who enroll in an inpatient program can expect to temporarily live in the facility where they receive care. This will endure the length of the program.
Dual Diagnosis Treatment
Molina healthcare insurance plans may cover dual diagnosis treatment contingent upon verified benefit coverage and the selection of an in-network provider.
Dual diagnosis treatment is a service that addresses addiction alongside co-occurring disorders, or mental health disorders that frequently occur in conjunction with addiction. In many cases these disorders are even the root of SUD.
This service combines mental health treatment approaches like therapy, counseling, and more to comprehensively treat the individual.
Outpatient Treatment Programs
Much like inpatient treatment, outpatient rehab may be covered at least partially by your Molina insurance plan. As a disclaimer, prior authorization and in-network care is required.
Often a step-down from inpatient care, outpatient treatment provides addiction care for set days and times, often several days a week for multiple hours.
Outpatient care allows individuals to continue living at home and is offered in variations such as partial hospitalization programs (PHP) and intensive outpatient programs (IOP).
Counseling & Behavioral Therapy
Molina policyholders will need to have their provider verify benefit coverage and find an in-network provider to receive coverage for counseling and behavioral therapy.
Counseling is a service that allows individuals to discuss their emotions, thoughts, and worries throughout their addiction treatment journey with their provider.
On the other hand, behavioral therapy is a kind of talk therapy that focuses on changing behavioral/thought patterns that exacerbate addiction.
It is often used as a mental health service and may come in many forms such as dialectical behavioral therapy (DBT) or cognitive behavioral therapy (CBT). Behavioral health services are part of a comprehensive treatment plan.
Continuing care services differ between individuals, so Molina coverage will depend on the type of service you receive.
Often also referred to as aftercare, continuing care is treatment services provided after you complete an addiction treatment program.
You and your case manager will determine what aftercare services are best for you, but some include counseling, therapy, support groups, and sober living.