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MagnaCare Insurance for Addiction Treatment

When searching for drug and alcohol addiction treatment, one of the first steps to take is verifying your insurance to determine how much your policy will cover for rehab expenses. If MagnaCare is your insurance provider, some or all of your drug and alcohol rehab will be covered, depending on the plan you have.

MagnaCare serves customers in New York, New Jersey, and Connecticut. With a network of over 130,000 doctors at 225 hospitals and care centers, over 1 million MagnaCare customers are promised access to a wide selection of healthcare providers to choose from.1-3

American Addiction Centers (AAC) strives to provide you with the most updated information on each carriers’ addiction insurance coverage, but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels.


Does MagnaCare Cover Addiction Treatment?

The short answer is yes. Your MagnaCare insurance will cover at least part of your addiction treatment. Depending on the plan you have, your treatment may be fully or partially covered.

The Affordable Care Act (ACA) requires all insurance companies to provide some type of coverage for drug and alcohol treatment. The ACA states that all health insurance plans must cover behavioral health treatment (e.g., psychotherapy and counseling), mental health inpatient services, and substance use disorder (SUD) treatment.4

What you are financially responsible for paying for depends on the state you live in, the particular healthcare plan you have, treatments sought, and whether you choose an in-network facility or not.

No matter what treatment facility you choose and what insurance policy you have, you will likely be responsible for paying some out-of-pocket costs, including:

  • Deductible: the amount you are required to pay out-of-pocket before your insurance coverage kicks in
  • Co-pay: a fixed amount you pay when you receive a covered service
  • Co-insurance: a fixed percentage of treatment costs you must pay before or after you reach your deductible

MagnaCare typically requires a pre-authorization form in order for coverage to kick in for your addiction treatment. This means that you will need to get a letter from your family doctor stating that treatment is medically necessary. In addition, your pre-authorization may include only a certain number of days that coverage is provided in a calendar year. Therefore, it’s important that you understand that if you stay in treatment longer, or you attend inpatient treatment more than once in a calendar year, you may be financially responsible for any time spent in treatment that goes beyond what is approved by MagnaCare.


How to Check Your Insurance Benefits?

Before choosing the right rehab treatment center for you, check your MagnaCare policy benefits to determine which costs will be covered by your insurance company and which will be out-of-pocket for you. Call the number on the back of your insurance card, or log in to your account on MagnaCare’s website to learn more about what your specific policy plan covers.

Knowing exactly what MagnaCare plans cover 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. For more information on MagnaCare insurance plans and to check what your plan covers, call , click here, or fill out the form below.


What Are the Coverage Levels and Plans for MagnaCare?

MagnaCare is technically not an insurance company. Rather, it is a third-party administrator (TPA) that administers health plans for your employer. That means they handle the “business” side of insurance claims, including your ID cards, answering questions, talking to your healthcare providers, and making payments and communicating decisions based on your claims on your employer’s behalf.

MagnaCare does not offer plans to individuals and families—they only offer group solutions. The company works with organizations (employers) to design self-funded health plans that meet that particular organization’s budgets.5 MagnaCare offers any plan design for organizations based on their needs and budgets, including PPO, HDHP/CDHP, EPO, and POS plans.

Details about your particular plan can be determined by calling the number on the back of your insurance card or speaking with human resources in your place of employment to learn exactly what is covered.

MagnaCare and Medicare and Medicaid

Some individuals who have MagnaCare through their employer may also qualify for Medicare. Contact MagnaCare directly to determine if you qualify for financial assistance through Medicare.

Medicare is a nationwide insurance program for anyone aged 65 and over, and anyone with a disability. It contains Part A and Part B. Medicare Part A provides benefits for hospitalization, extended care, and addiction treatment. Medicare Part B provides medical-surgical benefits and is available to beneficiaries who pay a monthly premium.

Medicaid is a government-funded health insurance coverage offered to low-income individuals and certain disabled individuals. Generally speaking, those who are already insured through their employer with MagnaCare typically do not qualify for Medicaid.6


Do Treatment Centers Need to Be In-Network?

In most cases, you will need to seek treatment at a facility that is in-network with MagnaCare in order to receive your full benefits. Even if you choose a treatment facility that is in-network, you may still be responsible for some of the treatment costs.

If you choose a facility that is out-of-network, you may be responsible for all of the costs of your addiction treatment. You may be able to discuss financing options such as a payment plan or scholarships offered by the facility.


What Different Types of Addiction Treatment Does MagnaCare Cover?

MagnaCare offers coverage for most addictions, including drugs, alcohol, and prescription medications. If MagnaCare is your insurance provider, your policy may cover the following for addiction treatment:

  • Detox services: Detox helps you withdraw safely from drugs and/or alcohol under 24/7 medical supervision to ensure your symptoms are addressed as they arise.
  • Inpatient or residential care: Live-in/residential treatment typically involves living in the treatment facility on-site, for anywhere from 15-90 days, depending on the facility and your needs.
  • Partial hospitalization programs: An intensive form of treatment that is sometimes referred to as day treatment. You may live at home, but your days must be spent in treatment.
  • Intensive outpatient: You can live at home but must attend 10-12 hours a week visiting the treatment center to complete the program.
  • Outpatient treatment: Optimal for those who have completed residential/inpatient treatment and prefer ongoing care and support in their sobriety. Outpatient treatment may involve attending treatment 3 evenings/week.

Knowing what your MagnaCare insurance plan covers can help you avoid unexpected costs while you or your loved one are receiving treatment, providing you with much-needed peace of mind without worrying about financial concerns on the journey to recovery.

For more information on MagnaCare insurance and to check what your plan covers, you can call the number on the back of your insurance card or call us . We’d be happy to help.


What Should I Do if MagnaCare Won’t Cover the Total Cost of Rehab?

If your MagnaCare insurance policy does not cover rehab expenses, it’s important not to let that stop you from attending treatment and getting sober. Getting treatment now is the most important focus. Most rehab facilities offer payment plans so you can gradually pay your costs back over time. Others offer grants and scholarships to those with financial need. Speak with admissions specialists at any rehab centers you are considering to ask about their financing and scholarship options.

These resources provide more information about other ways to pay for rehab beyond what your MagnaCare insurance covers:

Choosing to attend rehab for an SUD is arguably one of the most important steps on your path to wellness and recovery. Here at American Addiction Centers (AAC), we are glad you’ve made this decision. There is help available and hope for a better tomorrow. Your MagnaCare policy and benefits can help you pay for treatment so you can focus on what matters: your sobriety and long-term recovery.


Sources

  1. MagnaCare. (2021). Our Story.
  2. MagnaCare. (2021). Health Plan Management.
  3. MagnaCare. (2021). Who We Serve.
  4. Healthcare.gov. (2021). Mental Health and Substance Abuse Coverage.
  5. MagnaCare. (2021). Members.
  6. MagnaCare. (2021). Networks and Health Plans.

More resources about MagnaCare Insurance for Addiction Treatment: