Overview of Magellan Insurance for Drug and Alcohol Rehab
Magellan Health is a managed care company and health care provider that specializes in mental and behavioral health care. Currently, it provides services and coverage to more than 30 million customers with its network of 77,000 mental health providers, many specializing in treating addiction.1
Because Magellan Health specializes in mental health and behavioral health treatment, they may be the right fit to help you get the care you need as well as gain a better understanding of your health insurance benefits. Your exact coverage details may vary based on your health plan and location, so it’s important to call the number on the back of your insurance card and speak with a Magellan representative to learn more about your health benefits.
Types of addiction treatment that may be covered by your Magellan insurance or Magellan Behavioral Health Coverage include:
- Medical Detox
- Inpatient Rehab.
- Partial Hospitalization Programs (PHPs)
- Intensive Outpatient Programs (IOPs)
- Outpatient Rehab.
Since the extent of substance use disorder coverage can differ between Magellan Health plans, it’s recommended that you check your policy details or reach out to your benefits coordinator to understand your specific benefits.
Types of Addiction Treatment Covered by Magellan
While recommended treatments may vary, as will plan coverage details, the following is a list of common drug rehab treatment types:3
- Outpatient rehab: Designed for those who need to receive regular treatment but don’t need intensive monitoring or rehabilitation, outpatient rehab programs involve a patient traveling to a facility to seek treatment during the day (e.g., therapy or medicine), but then returning home following that appointment.3 If you need outpatient rehab or therapy, your Magellan plan will most likely cover it in some capacity.
- Inpatient or residential rehab: Designed for those who need round-the-clock and intensive care (e.g., detoxing patients), inpatient alcohol rehab covered by Magellan insurance, or residential rehab, involves a patient entering a facility and living there until they’re stable enough to be discharged.3 If you or your loved one needs inpatient or residential rehab treatment, it may be covered in some capacity under your Magellan plan.
- Intensive outpatient programs (IOPs): IOPs are typically the recommended course of treatment for those who need more care than the traditional outpatient program would provide, but don’t necessarily need to remain in a facility for constant supervision or care.4 IOPs generally are covered in some capacity under Magellan Insurance plans.
- Partial hospitalization programs (PHPs): Like IOPs, PHPs combine elements of different treatment methods. With a PHP, a patient would be in a structured day or hospital program and often allowed to return home at night.5 Generally speaking, PHPs are covered under most health plans in some capacity, including your Magellan plan.
Does Magellan Cover Behavioral Health Services?
Yes, Magellan Health is a leading provider of behavioral health services. They specialize in managing mental health and substance use disorder benefits. Magellan’s primary expertise lies in mental health conditions and substance use disorders. They have a large network of providers specializing in these areas. They offer coverage for a wide range of behavioral health services, including:
- Therapy and counseling (individual, group, family).
- Medication management.
- Crisis support.
In-Network vs. Out-of-Network Rehab Facilities
Choosing the right rehab facility is a crucial step in your recovery journey, and understanding your insurance coverage plays a big part in that decision.
- In-network rehabs with Magellan Insurance typically have negotiated rates and discounts for you, as the patient. When you see an in-network provider, your care is typically covered at a higher percentage, and sometimes fully covered, depending on the plan.
- Out-of-network providers typically do not have negotiated rates or discounts, so you’ll have to pay more for services versus than what you might may with an in-network provider.
To find an in-network provider and keep your health care costs as low as possible, give us a call at . American Addiction Centers’ facilities are often considered in-network providers under many different health care plans.
How To Verify Your Magellan Insurance
There are a number of ways you can verify your insurance and check your benefits.
- Login to your membership portal.
- Speak with your plan administrator.
- Call the number on the back of your Magellan insurance card.
- Give us a call or use our online verification tool.
Magellan Insurance Plan Options for Drug Rehab
Magellan does offer some HMO and PPO plans directly, particularly Medicare Advantage plans. So, in some cases, you might actually have a Magellan HMO or PPO as your primary insurance. However, Magellan’s primary role is as an augmentative element to existing health plans. They specialize in managing behavioral health benefits for other insurance companies. So your main insurance provider may be Aetna, BCBS, or Cigna, but Magellan manages the behavioral health portion of your plan.
So, while Magellan can be your primary insurer with their own HMO or PPO plans, they more often act as a specialized partner to enhance the behavioral health coverage of other insurance plans.
This “behind-the-scenes” role allows Magellan to focus on what they do best: providing access to quality mental health and substance use disorder care.
Alternative Payment Options if Rehab is Not Fully Covered
Depending on your plan or treatment program, it’s possible that you may not receive full or partial insurance coverage for your rehab. This means that you may be responsible for all or part of your treatment costs. If this happens, it’s important to not panic or forego getting treatment. There are a number of options to help you cover the cost of rehab, including:
- VA Assistance for Rehab Costs.
- Government-funded programs
- Sliding scale fees offered by rehab centers.
- Financing options.
