Magellan Insurance Coverage for Addiction Treatment
Magellan Health is a health insurance company that offers various insurance plans, including health maintenance organization (HMO), point of service (POS), preferred provider organization (PPO), health savings accounts, health reimbursement accounts, individual health plans, and Medicare plans. If you have Magellan insurance and are looking for drug and alcohol addiction treatment, you likely have some questions about what is covered by your insurance policy and what out-of-pocket expenses you can expect. Those with Magellan may be able to use their insurance benefits to cover some or all of the costs of addiction treatment.
How to Check Your Insurance Benefits?
Before you decide which rehab center might be best for your needs, it’s important to check your insurance benefits to understand what costs are covered by your insurance provider, and which ones you are responsible for. Knowing exactly what your Magellan plan covers can give you peace of mind while you or your loved one is in rehab. You can do the work of getting and staying sober without worrying about unexpected costs or financial struggles. Call the number on the back of your insurance card to learn about your exact coverage.
Does Magellan Health Cover Addiction Treatment?
Yes, any Magellan Health Services plan that includes LifeResources coverage will pay for at least part of any drug or alcohol rehabilitation program that has been deemed necessary by its Employee Assistance Program (EAP). Therefore, the first step is to contact one of these counselors and receive a treatment referral.
The Affordable Care Act (ACA) mandates that all insurance plans, including those offered by Magellan, must provide some degree of coverage for the medically-necessary treatment of mental health disorders, including substance use disorder.3 The amount of coverage you have can vary widely based on your state of residence, whether the facility is in- or out-of-network, the length of your stay, and your insurance plan level. The cost of drug and alcohol addiction treatment will vary from person to person and will also depend on the rehab center, the type of program attended, and specific services received.
Do Treatment Centers Need to be In-Network?
In-network providers have a contract with the insurance carrier to offer services at a set price. This means that your out-of-pocket expenses will typically be lower than if you choose an out-of-network facility. In some cases, you may even be responsible for the full cost of rehab if you choose an out-of-network facility.
Whenever possible, try to choose a facility that is in-network with Magellan. If you are unable to find an in-network provider or prefer a facility that is out-of-network, you may be able to work out a payment plan with the facility so you can pay back the cost of treatment over time.
What Different Types of Addiction Treatment Does Magellan Cover?
Your Magellan insurance plan may cover the following addiction treatment services:3
- Detox services: In some cases, you may need assistance when detoxing from drugs and alcohol, which can potentially be uncomfortable, painful, or even life threatening. Medical detox helps you safely withdrawal from drugs and alcohol, as you’ll receive around-the-clock medical supervision. You might also be given medications to help minimize withdrawal symptoms.
- Inpatient or residential care: Inpatient/residential live-in treatment centers provide drug and alcohol rehab while you live onsite at the facility. Most inpatient programs last anywhere from 15–90 days, depending on the program you’re in and your individual needs.
- Partial hospitalization (PHP): Partial hospitalization programs give you the opportunity to live at home while attending treatment during the day.
- Intensive outpatient: Intensive outpatient programs involve attending treatment programs a few evenings a week. In an intensive outpatient program, you can live at home and even go to work during the day.
- Outpatient treatment: Individuals who have completed inpatient treatment often attend outpatient treatment for ongoing support on their journey to sobriety. You live at home and spend 10–12 hours a week at the treatment facility for therapy and support.
Your total out-of-pocket costs for treatment depend on the specific Magellan plan you have. Monthly premiums, copays, deductibles, and other potential costs all vary depending on the plan. But, with Magellan insurance, at least a portion of your costs should be covered under your plan.