Type Size:

Value-Added Services

What are Value-Added Services?

These are services that Molina Healthcare offers in addition to the Centennial Care Benefit package.

How do I get these services?

  • Dental Varnish and School Sports Physicals do not require prior authorization.
  • Non-pregnancy related services for women enrolled in Centennial Care for maternity only require prior authorization based on Molina Healthcare’s Prior Authorization Matrix. Your Molina Healthcare provider will know what requires prior authorization.
  • All other Value-Added Services require prior authorization. Your Molina Healthcare Care Coordinator or provider can assist you with getting a prior authorization.

Molina Healthcare covers the following Value-Added Services:  

Dental Varnish
Description: Prescription strength fluoride product delivered to the dentition by a child's PCP. For members with moderate to high dental caries risk. Please note this is a Medicaid covered service for children 3 years and older.

Eligible Population: Available to children 0-3 years old. Members in the Alternative Benefit Plan (ABP) are not eligible.

Prior Authorization: No Prior Authorization is required to access this service.
 
Electroconvulsive Therapy (ECT)
Description: For use as a treatment for severe depression that has not responded to other treatment. Short-term ECT is given for a limited number of times per week for a limited number of weeks. Maintenance ECT is provided as required; maintenance ECT is provided less frequently than short-term ECT, i.e. once per week/two weeks/month. Short-term ECT & maintenance ECT is typically for adults but will evaluate for pediatric population on a case by case basis.

Eligible Population: Medicaid members only. Members in the ABP are not eligible.

Prior Authorization: A Prior Authorization is required to access this service.
 
Infant Mental Health
Description: Infant Mental Health Services (IMH) targets children (0-5) in distress or with clear symptoms indicating a mental health disorder. IMH address problems with attachment and relationships in families, focus on the parent-child relationship, and are designed to improve infant and family functioning in order to reduce risk for more severe behavioral, social, emotional, and relationship disturbances as infants get older. Relationship-focused interventions to the parents, foster parents, or other primary caregivers with infants and toddlers. $100,000 total program cost per calendar year for all IMH services rendered.

Eligible Population: Benefit available to parents/foster parents/caregivers of Members 0 - 5 years old.

Prior Authorization: A Prior Authorization is required to access this service.
 
Non - General Acute Care Hospital Based Inpatient Detox-ABP
Description: This service will be provided for individuals with substance abuse disorders in need of detoxification in a non-general acute care hospital inpatient setting. Services will be provided by qualified substance abuse treatment centers including but not limited to free standing psychiatric hospitals. These services can be effective alternatives to higher levels of care (e.g. General acute care hospital based detox). $250,000 total program cost per calendar year including ABP Non-General Acute Care Hospital Based Inpatient Detox and Medicaid Non-General Acute Care Hospital Based Inpatient Detox and Outpatient Detox.

Eligible Population: These services will be provided to ABP members, with substance abuse disorders in need of detoxification in a non-general acute care hospital inpatient setting. Inpatient length of stay: 5-7 days. Services are limited to 1 non-non-general acute care hospital inpatient detox admission per member per calendar year. Members with serious comorbid medical conditions may not be appropriate for these services.

Prior Authorization: A Prior Authorization is required to access these services.
 
Non - General Acute Care Hospital Based Inpatient Detox and Outpatient Detox-Medicaid
Description: These services will be provided for individuals with substance abuse disorders in need of detoxification in either a non-general acute care hospital inpatient setting or in an outpatient setting, according to individual clinical needs. Services will be provided by qualified substance abuse treatment centers including but not limited to free standing psychiatric hospitals. These services can be effective alternatives to higher levels of care (e.g. General acute care hospital based detox). $250,000 total program cost per calendar year including ABP Non-General Acute Care Hospital Based Inpatient Detox and Medicaid Non-General Acute Care Hospital Based Inpatient Detox and Outpatient Detox.

Eligible Population: These services will be provided for individuals, age 14 and above, with substance abuse disorders in need of detoxification in either a non-general acute care hospital inpatient setting or in an outpatient setting. Inpatient length of stay: 5-7 days. Outpatient length of stay: up to 10 days. Services are limited to 1 non-non-general acute care hospital inpatient detox admission or 2 outpatient detoxes per member per calendar year. Members with serious comorbid medical conditions may not be appropriate for these services. Members in the ABP are not eligible.

Prior Authorization: A Prior Authorization is required to access these services.
 
Non Maternity Related Services to Women Enrolled in COE 301 for Maternity-Related Services Only
Description: All Medical, Behavioral Health, Dental, Vision and Transportation for all pregnant women enrolled in maternity-only COE. Women in this COE are provided Medicaid benefits for pregnancy-related services. Molina is providing the full Medicaid benefit to these women, with the exception of Long Term Care and Community Benefits.

Eligible Population: Pregnant women enrolled in maternity-only COE. Members in the ABP are not eligible.

Prior Authorization: Certain services require a Prior Authorization. Please refer to Molina's member handbook for services requiring prior authorization.
 
Peer Driven Recovery Oriented Services
Description: Peer driven recovery oriented services will include the utilization of Drop-in Centers and Wellness Centers to obtain access to behavioral health recovery services to improve quality of life and health outcomes. $200,000 total program cost per calendar year including ABP and Medicaid.

Eligible Population: Adults, children, adolescents and families with behavioral health needs. Both ABP and Medicaid members can access this service.

Prior Authorization: Based on availability.
 
Post Discharge Meals
Description: Designed to support Molina members as they transition from a hospital or SNF inpatient setting, back into the home and community. Home delivered meals to members after discharge from a hospital or SNF inpatient stay, at no charge to the member. Meal types vary, and can include regular, vegetarian, diabetic/low sodium, renal, kosher and pureed selections. Provides up to forty-two (42) home delivered meals per calendar year to homebound members after hospital discharge, to be prepared by USDA or state inspected facility. Homebound means an individual who has difficulty leaving home without assistance because of a disabling physical, emotional, or cognitive impairment.

Eligible Population: Both ABP and Medicaid members can access this service.

Prior Authorization: A Prior Authorization is required to access this service.
 
Post Hospitalization Homeless Lodging
Description: Allows homeless members to stay in hotels for up to two weeks during the transition from hospital to home. Required care such as infusion therapy or skilled nursing services would be provided in this setting.

Eligible Population: Member must be homeless, requiring additional services. Limited to two weeks. Members in the ABP are not eligible.

Prior Authorization: A Prior Authorization is required to access this service.
 
School Sports Physicals
Description: Physical examinations and completion of paperwork so that members can participate in sporting activities. This is a medical examination for administrative purposes rather than medical diagnosis or treatment.

Eligible Population: Available to children 12 -18 years old. One physical per calendar year. Members in the ABP are not eligible.

Prior Authorization: No Prior Authorization is required to access this service.
 
Traditional or Non-Traditional Healing
Description: Provides spiritual services with cultural sensitivity for traditional or non-traditional healing rituals. The Traditional or Non-Traditional Healing Benefit helps members using traditional or non-traditional healing services. Members may use the healer of their choice for the healing ceremony of their choice. $100.00 per member per calendar year. Benefit excludes Self-Directed Community Benefit members.

Eligible Population: Both ABP and Medicaid members can access this service.

Prior Authorization: No Prior Authorization is required to access this service.
 
Transitional Living Services (Adults & Adolescents/Young Adults)
Description: Supervised voluntary residential treatment, habilitative, and rehabilitative services in a structured, community-oriented environment. An interim residential program offering 24-hour supervised voluntary residential treatment, habilitative, and rehabilitative services in a structured, community-oriented environment. Also called "transitional living", the services are designed for individuals who have the potential and motivation to ameliorate some skills deficits through a moderately structured rehabilitative housing program. $200,000 total program costs per calendar year.

Eligible Population: Members age 17 years and older. 180 day maximum per member per calendar year. Average Length of Stay is three (3) to five (5) months per Member. Medicaid Members only. Members in the ABP are not eligible.

Prior Authorization: A Prior Authorization is required to access this service.​​​​​

This link will take you away from the Medicare section of MolinaHealthcare.com

This link will take you away from the Dual Options section of MolinaHealthcare.com

You are about to leave the Molina Healthcare website.

This link will take you away from the Dual Options section of MolinaHealthcare.com

This link will take you away from the Medicare section of MolinaHealthcare.com

You are leaving the Molina Healthcare website. Are you sure?

This information is for Doctors and
Health Care Professionals only.

X Please wait. New Mexico info is loading. Cancel