Networks change. We verify your specific Molina plan before your first visit; call with your member ID and we will confirm benefits, copay and any referral or authorization requirements.
Also appears on cards as: Molina Healthcare, Molina Healthcare of South Carolina, Molina Marketplace, Molina Medicare.
Molina Healthcare is a national insurer focused on government programs. In South Carolina, Molina Healthcare of South Carolina is one of the Medicaid managed care plans under Healthy Connections, and it also offers marketplace and Medicare Advantage dual-eligible plans. In Florida, Molina offers marketplace plans and Medicare Advantage plans for people with both Medicare and Medicaid, having exited the state's Medicaid managed care program after the 2024 contract cycle. Which product you hold determines your benefits. Medicaid members pay nothing for outpatient psychiatry. Marketplace members pay according to their metal tier. Dual-eligible Medicare members typically pay $0 for mental health visits. Referrals are not required for behavioral health on any Molina product, and telehealth psychiatry is covered at parity for members in their home state.
Molina applies its clinical policies to interventional treatments. Transcranial magnetic stimulation requires prior authorization and documentation of major depressive disorder with failure of at least two antidepressants and current severity scores, and South Carolina Medicaid members are subject to the state's coverage rules for TMS. Spravato requires prior authorization with treatment-resistant depression, a concurrent oral antidepressant and REMS-certified administration. Because these services are provided at our Florida offices, South Carolina Molina members should discuss coverage and travel with us before an authorization is submitted.
What we check before your visit
- Whether your plan is in network at the office you chose and for telehealth
- Your copay or coinsurance for an evaluation and for follow-ups
- Whether a primary-care referral is required (common with HMO plans)
- Prior-authorization criteria for Deep TMS and Spravato, if those are being considered
Frequently asked questions
Does Stedfast Psychiatry accept Molina?
Stedfast Psychiatry accepts Molina Healthcare plans at our South Carolina offices for Medicaid, marketplace and dual-eligible members, and Molina marketplace and Medicare Advantage plans at our Florida offices where contracted. Networks differ by product, so confirm your specific plan with Molina member services or ask our front desk to verify.
Is there a copay for psychiatry on Molina Medicaid?
No. South Carolina Medicaid members on Molina pay $0 for covered outpatient mental health visits, including psychiatric evaluation, medication management and therapy. Marketplace members pay the copay or coinsurance shown in their plan summary. Dual-eligible Medicare Advantage members typically pay $0 for mental health visits.
Does Molina cover telehealth visits?
Yes. Molina covers video psychiatry visits at the same benefit level as office visits for members located in South Carolina or Florida during the appointment, depending on which state issued the plan. Telehealth is covered for Medicaid, marketplace and Medicare members. You must be in the state where your plan is issued.
Does Molina cover Deep TMS?
Molina covers TMS for major depressive disorder with prior authorization when you have documented failure of at least two antidepressants and current severity scores. South Carolina Medicaid members are subject to state coverage rules. Because our TMS program is at Palm Beach Gardens, Florida, South Carolina members should discuss logistics with us before we submit a request.
Is Spravato covered by Molina?
Molina covers Spravato with prior authorization for treatment-resistant depression when you are taking an oral antidepressant and receive treatment at a REMS-certified clinic. Coverage varies by product and state program. Our staff verify your specific plan, submit the authorization and coordinate drug supply at our Boynton Beach, Palm Beach Gardens and Royal Palm Beach offices.