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Portland Maine’s Pine Tree Recovery Center is a world-class medical detox facility offering substance-specific medically assisted detoxification programs. As a premier detox facility on the front lines of the east coast opioid crisis, it’s our mission to help members of the Portland community heal physically, emotionally and spiritually. This includes ensuring that anyone who wishes to use insurance to participate in treatment with us can do so. After reviewing the frequently asked questions about your Molina Healthcare plan below, call us anytime for more information or to begin the admissions and assessment process.

Does Pine Tree Recovery Center Accept Molina Healthcare?

Yes. Molina Healthcare offers health insurance benefits to those who qualify for Medicaid, Medicare or both. In some states, Molina offers individual health plans through the health insurance marketplace. Molina is one of the leading partners in government-assisted health care. From humble beginnings in the 1980’s in California, Molina now insures close to 2 million Americans in almost twenty states.

Molina’s benefits for alcohol and substance dependency treatment services fall under Molina Behavioral Health benefits. In some states, Molina offers a stand-alone behavioral health plan to cover just these services as either a supplemental or stand-alone policy. Behavioral Health benefits include both inpatient residential treatment and outpatient services. Your plan’s benefits may also extend to medications prescribed to reduce withdrawal symptoms.

The exact limits of each individual’s coverage will vary depending on in which state your insurance was issued, whether your Molina Healthcare marketplace plan has bronze, silver or gold level coverage, and your plan’s deductible and copayment amounts. Thanks to the federal Mental Health Parity and Addiction Equity Act of 2008, no marketplace health insurance plan that provides mental health or substance abuse coverage can place benefit limits on that coverage that are less favorable than limits for medical or surgical benefits.

In addition, Molina Healthcare may require a referral or pre-approval for residential treatment center admissions, inpatient admissions or outpatient detoxification programs before benefits apply. Referrals are available through your primary care provider – a Pine Tree Recovery specialist can help ensure that you receive the referrals, correct pre-approval permissions, and quick access to the care that you need. Our goal is to ensure that your health insurance is maximized to minimize your out of pocket costs.

Will Molina Healthcare Cover the Entirety of My Treatment?

The specific limits of your coverage are dependent on your unique Molina Healthcare plan. Each plan will have a deductible, as well as a copayment amount, and these may vary widely according to your plan. Your deductible could be as low as $100 or upwards of $5,000 and is the amount you must pay out of pocket before your Molina Healthcare benefits are applicable. Copayment amounts are a one-time fee for any service or medication and can be as low as $5, or more than $500 for emergency visits.

If your Molina Healthcare plan is a marketplace plan, it holds the category name of bronze, silver or gold. Each of these categories have their own ranges for deductibles, copayments and coinsurance. Coinsurance is the amount your plan will cover after your deductible has been met. Typically, bronze level plans have high deductibles, and cover approximately 60% of total medical care costs, but offer the lowest monthly rates. On the opposite end of the spectrum, gold level plans have low deductibles, and typically cover up to 75% of medical care costs at higher monthly rates.

Your Molina Healthcare policy may cover some or all of the costs associated with detoxification treatment and related medications, as well as some or all of the cost of therapeutic services as an inpatient or outpatient client. These services may include group and personal therapy, family therapy, and other aftercare programs. Depending on the state in which your Molina Healthcare plan originated, you may have additional benefits available through Molina Behavioral Health.

Your out of pocket expenses may depend upon additional factors including a past history of treatment for substance abuse, the details of your comprehensive and individualized treatment plan, and your policy’s deductible and copayment requirements. Depending on your specific policy, substance dependency recovery services may require pre-authorization. You may be required to provide documentation that includes referrals from your primary care provider.

The best way to obtain necessary pre-authorizations and determine exactly what your plan covers is to call a Pine Tree Treatment Advisor at (888) 693-1751. We’re here for you 24 hours a day, 7 days a week.

How Can I Find Out if My Individualized Treatment Plan is Covered?

Here at Pine Tree Recovery Center, our goal is to get you into treatment without delay. Your health insurance provider most likely has this very same goal. No one should ever undergo detoxification outside of the supervision of a health professional which deems safe and medically supervised treatment a medical necessity. In fact, recent laws have required health insurance plans in many states to reduce pre-authorization requirements in order to speed up access to medically necessary care.

Individualized treatment programs at Pine Tree Recovery Center may include detoxification treatment and related medications, as well as therapeutic services as an inpatient or outpatient client. This includes group and personal therapy, family therapy, and other aftercare programs. At Pine Tree Recovery Center, we will work closely with your Molina case manager to ensure that you receive the necessary care and that your health insurance benefits are maximized. This is our commitment to you from admittance through aftercare planning.

I Have Molina Healthcare Insurance, How do I Begin?

The quickest and easiest way to ease your concerns and understand your insurance benefits is to contact a Pine Tree Treatment Advisor today. We are available 24 hours a day, 7 days a week at (888) 693-1751 to answer questions about your policy and how you’re covered. All phone calls are completely confidential, and it often takes just minutes to review your options.

For the quickest way to find out about your Molina benefits and how they may reduce your out-of-pocket expenses, you may call us at anytime to speak with a Treatment Advisor. Our phone call is completely confidential, but you should be prepared to share the following:

• Your full name and date of birth
• Your policy holder’s name
• Your policy’s group and member number

We believe in the efficacy of our services and will fight to ensure that anyone who wishes to use insurance to participate in treatment with us can do so. Allow a Pine Tree Treatment Advisor to ease your concerns, and this time can be one of promise and hope.