Molina Healthcare provides different plans for families and individuals who qualify for government-sponsored programs. Molina Healthcare does contract with state governments and provides health plans, which does include Medicaid and Medicare, and plans through the Molina marketplace. Molina Healthcare does help families and individuals within the state of California, and within the plans, you can find basic coverage for substance abuse treatment. The extent of coverage will depend upon the plan, and Medicare and Medicaid plans do have some service providers that will help with treatment for a drug or alcohol problem. Substance abuse is a dangerous problem, and many addicts do not get help because of the barriers they do face. Health insurance plans provided by Molina Healthcare will help families, and addicts gain access to the drug treatment centers in California they need. Drug and alcohol abuse does not have to be a life-long problem, and with the right help, any type of drug problem can be successfully overcome.
Per Molina Healthcare, the Molina Dual Options offers benefits to support mental health and substance abuse treatment needs. Members of Molina Healthcare will work with a case manager who will help them find the proper provider, schedule appointments, arrange transportation, and assist with other support needs. Every health insurance plan is fundamentally different regarding the extent of coverage and what services are available. Most substance abuse treatment programs can help you walk through your policy and find out what is covered by your insurance plan. It is also beneficial to contact your Molina Healthcare provider and inquire as to what coverage is available to you and your family.
According to the UC Berkeley Labor Center, in a report titled California's Health Coverage Gains to Erode Without Further State Action, the Affordable Care Act resulted in historic increases in health insurance coverage within the state. There are over one million people in California who have subsidized insurance through Covered California, which is the health insurance marketplace within the state. Medi-Cal covers one out of three residents of California. In 2016 approximately 10.4% of California residents under the age of 65 lacked health insurance. Within this report, the rate of those with no insurance is projected to increase to 11.7% by 2020 and to 12.9% by 2023. Health insurance does help cover treatment for substance abuse, but every plan is inherently different.
Ask a Professional
Will my insurance pay for my rehab?
Maybe. Generally, the more severe the person’s addiction is, the more likely an insurance company will pay. The determining factor in getting coverage is if the insurance provider believes you need it. Insurance companies have a team of medical professionals that review all claims submitted. If they disagree that the person needs drug rehab, they don’t pay. All this being said, you must ensure the facility you want to attend accepts your insurance.
How do I know if a drug rehab accepts my insurance?
The easiest way to know if your policy is accepted is to call the treatment facility and give them your insurance information. They will be able to let you know if your insurance is accepted and verify your benefits to provide you with an idea of how much coverage you will get. Another way is to ask your insurance provider for a list of treatment facilities they work with. Doing so can save a lot of wasted phone calls to facilities that don’t accept your policy.
Do all health insurance policies cover drug rehab treatment?
Yes. Between the Mental Health Parity and Addiction Equity Act and the Affordable Care Act of 2010, all insurance providers must offer some form of substance abuse treatment coverage. The level of coverage varies between insurance providers and policies. Generally, more expensive private health insurance policies cover at a higher rate. It’s important to note that treatment facilities may limit the type of policies they accept. Even if your insurance plan has coverage, it may not be taken at the drug rehab you want to attend.
Can I purchase a policy specifically to cover treatment?
Technically, there’s no reason someone can’t purchase a policy specifically to cover their addiction treatment. What makes it challenging is private health insurance companies have developed tactics to prevent people from quickly purchasing a policy to avoid a significant expense like addiction treatment and then dropping the policy afterward. To prevent this financial loss, they only allow people to but policies during a certain period of the year, known as "open enrollment." Open enrollment can be a window as small as a few weeks out of the year, forcing people to wait until that time to get coverage. Other policies have "blackout periods" where major services like substance abuse treatment aren’t yet covered. Blackout periods usually last for one year, meaning the person must pay to keep the policy active for twelve continuous months before it will pay for any portion of an addiction treatment service.
How are Medicaid and private health insurance different?
Medicaid is free health insurance subsidized by each state and offered to qualified residents. To obtain Medicaid coverage, a person must demonstrate financial hardship that prevents them from getting private health insurance. Private health insurance is not free. It is purchased by individuals from insurance companies or may be provided through employment.
The questions from Addicted.org's "Ask a Professional" are answered by Michael Leach, CCMA. If you need further clarification on any of the questions above or have any other questions you can contact him directly at M.Leach@Addicted.org..
What's Next?
After completing a drug rehab in California covered by Molina, aftercare support is the next step. It is challenging to know what aftercare should be considered. However, the most common approaches include outpatient programs, sober living homes, sober coaching, or recovery meetings. Many of these aftercare options are available in California. The goal is to help you or your loved one continue the recovery journey.
