Getting Rehab Services in NM Using Molina Healthcare
If you’ve ever browsed the ACA Market, you’ve undoubtedly seen the many insurance companies listed for recipients to select as part of the Affordable Care Act. Choosing an appropriate provider and policy can be overwhelming if, for nothing else, the sheer number of different organizations on the list. Icarus is proud to be among the top rehabs that take Molina in New Mexico.
Molina is one of the most common insurance forms for individuals applying for Medicaid. They’re also one of the most frequently purchased forms of insurance on the ACA Marketplace, covering millions of Americans each year.
Whether you’re still shopping for insurance, or are a longstanding Molina policyholder looking for an alcohol or drug rehab, this guide will break down the details you need to know!
Who Is Molina Healthcare?
Long Beach, California-based Molina Healthcare provides managed healthcare services. Government-funded healthcare programs are implemented by the company to cover nearly 4 million people. Over 30 years have passed since the company was founded.
Medicare, Medicaid, and Marketplace exchange programs in some states are its primary focus areas, along with providing insurance directly through state governments through healthcare plans.
Using a Molina Healthcare Policy for Rehab
Molina Insurance requires a policy purchased through a state exchange or marketplace plan to provide coverage for mental healthcare services. Individuals who don’t buy a Molina health plan through a state exchange or marketplace must ensure that their private insurance policies include some mental and behavioral healthcare provisions. This includes requirements for substance abuse.
Molina also provides coverage for substance abuse. However, coverage will differ depending on whether the policy was purchased through a private market exchange or privately. The coverage should cover inpatient, residential, and outpatient treatment programs. However, it will vary depending on the way the policy was acquired, the state where the individual lives, and the policy itself.
Finding an Opiate Rehab that Takes Molina Insurance
Finding an opiate rehab that takes Molina insurance is simple. You have several options for accomplishing this goal, depending on how much time you’re willing to invest in finding the rehab you want.
The easiest way would be to contact our team at Icarus Behavioral Health and ask about your coverage details.
Whether you need preauthorization for Molina coverage for rehab often depends on the facility you choose, and Icarus will help make this process seamless and quick.
Does My Molina Policy Cover Alcohol Rehab?
In the same way as substance abuse rehab, Molina provides coverage for alcohol rehab as well. If you’re suffering from alcohol abuse disorder, don’t hesitate to work with Icarus to choose the right program for help.
The same protocol applies to finding an alcohol treatment center as the steps listed above for opiate rehabs. It’s worth noting that the amount of coverage you receive is ultimately based on your specific policy.
Does Molina Healthcare Cover Mental Health Services?
Yes, Molina Insurance covers mental healthcare. Molina Insurance covers all outpatient mental health services. These services include:
- Psychotherapy and individual and group mental health assessments.
- Psychological testing.
- Supplements and drugs for outpatients
- Consultation with a psychiatrist.
- Screening services for alcohol misuse
People with substance abuse disorder (drug addiction) are more likely to suffer from mental health issues such as anxiety, depression, and PTSD. This is a “dual diagnosis” or co-occurring disorder. The 2016 National Survey on Drug Use and Health found that more than 8 million people aged 18 and older who had substance abuse disorders also had co-occurring disorders.
It is best to treat mental health conditions simultaneously with drug and alcohol addiction for optimal treatment. In most cases, each disorder has an impact on the other. It is, therefore, a good idea to find a rehabilitation facility that provides treatment for both mental and addiction.
Substance use disorder is one of the essential elements that insurance companies must cover under the Affordable Care Act. Although their insurance policies cover certain mental health treatments while you are in rehabilitation, the exact amount of coverage depends on each policy.
What Length of Treatment Does Molina Cover?
Many people question what length of treatment Molina covers and how long of a stay they’re eligible for.
It is always important to determine whether government assistance programs cover treatment for substance abuse disorders. This includes whether the facility is a participant in the particular insurance program. Individuals with these policies should not consider using facilities that don’t accept certain types of insurance.
To be eligible for coverage, services must be deemed medically necessary. A specific treatment plan should be developed for each referral. This can be done by a doctor, intake staff, or other personnel. Many insurance companies won’t cover treatment for substance abuse disorders unless there is an addiction treatment plan. This is especially true for coverage of inpatient, residential, and partial hospitalization treatment programs.
The length of your treatment should also be outlined in your treatment plan. This will ultimately dictate how long of a stay you’re eligible for.
Remember, for many forms of treatment or certain durations in inpatient rehab; you’ll likely have to obtain a preauthorization form so your Molina agent is clear on why you require the services you’re requesting—for most rehab organizations, submitting these preapproval forms with the correct information only takes a few hours.
Molina says it provides a variety of services in behavioral health for its members. Contacting a Molina Healthcare case manager is the best way to go. They will provide all the necessary information and help you find the right provider for your needs.
Why would you want to select a provider in Molina’s network?
Why Choose an Out-of-Network Molina Provider?
Although an in-network facility provides benefits, using an out-of-network provider like Icarus can also offer advantages.
The first, and perhaps the most important, is that it will save you a significant amount of money, as our rates and accessibility are among the most affordable among all facilities in NM.
You’ll also have access to our facilities in Albuquerque as well as outpatient programs in Rio Rancho, giving you more locations than many other rehabs in New Mexico offer.
Molina Medicaid Plans and Rehabs that Take Molina
If you have a Molina Medicaid plan, the coverage you receive and the specifics of the plan are a little more concrete.
Molina also offers Medicaid programs via the State Children’s Health Insurance Programs (SCHIP). Medicaid is insurance for families with low incomes.
Medicaid is the single largest healthcare payer in the US. It covers mental health services, including disorder treatment. An individual’s eligibility for Medicaid depends on many factors, such as age, income, number of household members, disability, and other factors.
Molina Medicaid can be enrolled by individuals who visit the Health Insurance Marketplace. After completing the application, you can find out which programs you may be eligible for.
The federal poverty level (FPL) is the income requirement for Medicaid. Different states have different requirements regarding the income required to be eligible for Medicaid coverage. Individuals can earn incomes up to 50% above the FPL, depending on their situation. In some states, dependent children may be eligible for Medicare if they make twice as much. The following FPL levels apply:
- $11,770 for a household of one
- $15,930 per two-person household
- $20,090 per three-person household
- $44,250 for a four-person household
Individuals can use the Substance Abuse and Mental Health Care Services Administration’s Behavioral Health Treat Services Locator to find an insurance provider that accepts Medicaid. To be admitted to a treatment program for substance abuse disorders, one does not need to have an active Medicaid plan. Many programs will accept an applicant for Medicaid coverage once they have applied.
It’s worth noting that the service mentioned above is only available for Medicaid recipients of Molina.
How Can I Pay for Costs Not Covered by Molina?
There are several ways to pay for treatment costs that Molina won’t cover potentially. The best way is to contact the financial department of the rehab facility and ask to work out a payment arrangement. If your insurance company covers at least a portion, most rehabs are willing to work out an arrangement for the remainder.
If you can’t make an arrangement, you can search for grants and other state and federal assistance that may help you cover the rest of your treatment.
As a last resort, you could ask a family member to assist you or set up a crowdfunding campaign to cover your treatment. Many people have been successful in using crowdfunding to cover things like rehab.
Use Your Molina Coverage to Start Rehab Now
At Icarus Behavioral Health, we commonly work with Molina recipients who purchased their policy on the ACA Market or Medicaid recipients. If you receive Molina insurance coverage, contact a member of our admissions team today so we can get you enrolled in one of our excellent inpatient or outpatient programs today!