How Molina Mental-Health Coverage Works
Molina offers mental health benefits across Medicaid, Marketplace, Medicare Advantage, and dual-eligible plans. Your exact costs depend on the type of coverage you have and the state you live in.
If you’re enrolled in Molina Medicaid (programs like Apple Health in Washington, Medi-Cal in California, or STAR in Texas), mental health visits are covered at $0 copay, with unlimited medically necessary sessions included.
On a Molina Marketplace plan (Bronze, Silver, or Gold), therapy and psychiatry visits usually cost $20–$40 per session. For example, a Gold plan in Texas charges $20 per visit. Mental health services share the same deductible as your medical benefits, and there are no preset visit caps.
For members on Molina Medicare Advantage (HMO or PPO), therapy visits typically cost $0–$35 in office, and many plans cover virtual visits at $0. These benefits share the standard Medicare Part B deductible if one applies.
If you’re in a Dual Options plan (Medicare + Medicaid), you’ll generally pay $0 out of pocket, since the plan covers both the Medicare and Medicaid cost-shares for you.
Tip: Because Molina contracts vary by state, always check your Summary of Benefits or Medicaid handbook to confirm your exact coverage.
Coverage fast facts
- Unlimited medically necessary visits—no yearly cap.
- No referral required for routine outpatient therapy in most plans.
- Telehealth parity, often $0. Molina partners with Teladoc and other vendors to deliver no-cost video visits for many Medicaid and Marketplace members.
- Medication-management covered. Psychiatry visits bill at the same tier as therapy; your copay (or $0) usually applies.
Molina’s Mental-Health Provider Types
Molina’s network includes a full range of licensed mental health professionals, so you can find the right type of care for your needs.
- Therapists and counselors (LCSW, LMFT, LPC): These providers focus on talk therapy to help with anxiety, depression, stress, family challenges, and life transitions. They’re often the best first step if you’re looking for ongoing, weekly support.
- Psychologists (PhD or PsyD): In addition to therapy, psychologists can provide specialized testing—for example, ADHD evaluations, trauma-focused assessments, or other diagnostic work. They also offer advanced therapy approaches like EMDR or CBT.
- Psychiatrists (MD or DO): Psychiatrists are medical doctors who can diagnose and prescribe medication, making them especially important for complex conditions or situations where medication is part of treatment. Many also collaborate with therapists or psychologists to provide comprehensive care.
Tip: Many Molina members benefit from a team approach—meeting with a therapist regularly while checking in with a psychiatrist for medication management as needed.
Real-Life Use Case: How Carlos Found a Therapist Through Molina Medicaid
Profile: Carlos, 42, lives in Houston and is covered by Molina Medicaid. He’s been feeling anxious and overwhelmed balancing work, family, and financial stress. After a tough week, he decides to look for a therapist.
Day 1: Searching for Care: Carlos visits MolinaHealthcare.com and navigates to: Find a Doctor → Behavioral Health Providers. He enters his ZIP code and insurance type (Medicaid) to filter results. He sees eight in-network therapists within 15 miles of his home. He filters for:
- Virtual appointments
- Evening hours
- Specialties in anxiety or CBT
Three therapists remain, all accepting new Molina Medicaid patients.
Day 2: Booking the Appointment: Carlos calls the first therapist and confirms they accept Molina Medicaid and offer video visits. He books a Tuesday evening virtual session for later that week. Cost: $0 (Molina Medicaid covers therapy at no cost to members)
Day 10: Continuing Care: After several sessions, the therapist recommends Carlos speak to a psychiatrist about possible medication support.
Day 12: Psychiatry Appointment: Carlos calls Molina Member Services for help finding an in-network psychiatrist. They refer him to a local provider offering telepsychiatry appointments. He books a 30-minute video consultation for the next available slot. Cost: $0 (psychiatry is also fully covered under Molina Medicaid)
Helpful Tip for Molina Medicaid Members: If no therapist or psychiatrist has an appointment within 10 business days, call Molina Member Services and ask for a network adequacy exception. This allows you to see an outside provider at no cost if access is delayed.
Step-by-Step: Booking Therapy Through Molina
- Log in or call. Visit your state’s Molina member portal or dial the number on your card. Say, “I’d like behavioral-health services.”
- Use the directory filters. Zip code, specialty (PTSD, couples, ADHD), language, telehealth, evening hours.
- Verify the green “In Network” badge. That’s your sign of an Molina in-network therapist; double-check by phone if unsure.
- Run the cost estimator. Expect $0–$40 depending on plan and setting. Medicaid is almost always $0.
- Check telehealth options. Teladoc and some local clinics bill at the same—or lower—rate than office visits.
- Book and complete intake forms. Online questionnaires speed insurance verification.
In-Network vs. Out-of-Network:
With Molina, it’s almost always best to stay in-network. You’ll typically pay $0–$40 per visit (or 20% after your deductible, depending on your plan). Your provider will handle all the claims filing for you, pre-authorization is rarely required, and you’ll have access to Molina’s own telehealth portals.
If you decide to go out-of-network, that option is only available with Marketplace PPO plans. Costs are higher—you may pay 40–60% coinsurance plus any balance billing from the provider. You’ll also need to file claims yourself, and pre-authorization is more common. Out-of-network care also doesn’t connect with Molina’s telehealth systems.
Tip: If you can’t book an in-network appointment within 10 business days, ask Molina for a network-adequacy exception. Under mental-health parity rules, they may approve an out-of-network provider at in-network rates, ensuring you get timely care without paying extra.
Digital & Telehealth Options
Molina makes it simple to access mental health support from home through a mix of live telehealth visits and self-guided tools.
With Teladoc for Molina, you can connect by video with licensed therapists or psychiatrists. For most Medicaid and Marketplace plans, these visits are covered at $0, making them one of the most affordable ways to get care quickly.
Through Molina Virtual Care portals (which vary by state), members can access both video and audio-only therapy sessions. Costs are typically $0–$35, depending on your plan and coverage type, and this option is available for both Medicaid and Medicare Advantage members.
For extra support between appointments, all members can use Molina’s Wellness hub, which offers self-guided tools like CBT-based modules, mindfulness exercises, and educational videos—completely free.
Tip: Just like office visits, all telehealth sessions count toward your deductible and out-of-pocket maximum. Choosing virtual care won’t cost more—it just gives you more flexibility.
Cost & Coverage
Molina’s mental health costs vary by plan type, but most members find the coverage affordable and straightforward.
If you’re enrolled in Molina Medicaid, therapy and psychiatry visits are covered at $0 per session, with no cap on the number of medically necessary appointments.
For members on a Molina Marketplace plan, costs depend on your tier. For example, a Gold plan in Texas lists $20 per therapy or psychiatry visit. Many Marketplace plans also include $0 telehealth visits through Teladoc, making virtual care both accessible and budget-friendly.
If you’re on a Molina Medicare Advantage plan, therapy typically costs $0–$35 per visit, while initial psychiatry evaluations are usually $0–$50. Many Advantage designs also waive the copay entirely for telehealth therapy or psychiatry sessions.
Tip: If the first counselor or therapist you try doesn’t feel like the right fit, don’t worry—you can easily switch. Just reopen Molina’s provider directory and book another in-network clinician. It’s penalty-free and encouraged, since the right match is key to making progress.
What to Do If You're Facing Long Wait Times
If you're having trouble booking a timely mental health appointment, here's how to advocate for yourself and get faster access to care:
1. Keep a Log of Every Call
Write down:
- Date of contact
- Name of the person you spoke with
The next available appointment they offered
This documentation is essential if you need to request an exception or file a grievance.
2. Contact Molina Care Management: Call the number on your Molina member ID card and ask to speak with a Behavioral Health Care Manager or Nurse Case Manager.They may be able to check for cancellations or help you find earlier availability across nearby ZIP codes.
3. Request a Network Adequacy Waiver: If no in-network provider is available within 10 business days, ask for a network adequacy exception. Under federal parity law, Molina is required to ensure timely access to behavioral health services. If needed, they must authorize an out-of-network provider at in-network cost.
4. File a Grievance Online: If delays continue, file a formal grievance through your Molina member portal or by calling Member Services. By law, Molina must respond within 30 calendar days.
FAQ’s
Does Molina cover therapy?
Yes. Outpatient therapy and medication-management visits are essential benefits in every Molina Medicaid, Marketplace, and Medicare Advantage plan. Cost ranges from $0 (Medicaid, many telehealth visits) to $35 (some MA office visits).
How do I find therapists that take Molina Healthcare near me?
Log in → Find Care → Behavioral Health, enter your ZIP, and check the “Accepting patients” box.
What’s the difference between a Molina therapist and a Molina Healthcare psychologist?
Therapists (LCSW, LMFT, LPC) focus on talk therapy. Psychologists (PhD/PsyD) can also conduct testing. Both are covered if in network.
Are Molina psychiatrists accepting new patients?
Many are—especially via Teladoc. Use the directory’s telehealth filter and “Accepting patients” tag.
Will my virtual session count toward my deductible?
Yes. Telehealth visits apply to the same deductible and out-of-pocket max as office visits.
