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Updated on March 10, 2022

Magellan Health Insurance For Addiction Treatment

Does Magellan Insurance Cover Rehab for Drugs and Alcohol?

Magellan Health is a managed health care provider. They specialize in behavioral healthcare. This includes substance use disorder (SUD).

Magellan Health was originally founded as a psychiatric hospital chain. They’ve handled mental and behavioral health issues from the beginning.

Now, Magellan Health provides healthcare coverage to more than 33 million people. In some cases, the company partners with other insurance providers who do not offer mental health care services.

People with Magellan Health coverage have access to a network of more than 77,000 mental health practitioners. Many of these professionals specialize in drug and alcohol addiction treatment.

Programs Magellan Health offers include:

  • Employee and employer assistance
  • Integrated behavioral health
  • Early detection
  • Children’s programs

Additionally, the company provides educational material, including videos and documents. 

Types of Addictions Magellan Covers

Magellan Health provides coverage for a variety of addictions and related mental health issues, including:

  • Drug addiction
  • Prescription drug addiction
  • Alcohol addiction
  • Depression
  • Anxiety
  • Post-traumatic stress disorder (PTSD)

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Rehab Options Magellan Covers 

Magellan Health offers coverage, in part or in full, for the following substance abuse treatment options:

Medical Detox

Medical detox is the first stage of drug and alcohol addiction treatment. Detoxification programs focus on keeping someone as comfortable as possible as they withdraw from drugs and/or alcohol.

In some cases, drug and alcohol detox programs involve medications. These reduce cravings and other uncomfortable withdrawal symptoms. 

Most detox programs include 24/7 medical supervision.

Medical supervision is important during this time. This is because some drug and alcohol withdrawal symptoms are life-threatening. Relapse rates are also high because cravings are intense during this phase.

Inpatient Treatment

Magellan offers coverage for a variety of inpatient treatment services.

Coverage varies among plans but might include:

Plans vary based on location and whether or not a service is in-network.

Most people pay a copay and must meet deductible requirements before Magellan Health contributes to the cost of inpatient treatment.

Outpatient Treatment 

Magellan health insurance offers coverage for a variety of outpatient treatment services.

Coverage varies by plan, but might include:

Plans vary based on location and whether or not a service is in-network.

Like inpatient treatment, most people pay a copay and must meet deductible requirements before Magellan Health contributes to the cost.

Two outpatient treatment programs Magellan Health covers include:

1. Intensive Outpatient Programs (IOPs)

Intensive outpatient programs (IOPs) offer a substantial level of flexible care. Participants typically attend addiction treatment for 3 to 5 nights a week. 

Intensive OP services occur in the mornings, afternoons, or evenings for about 3 to 4 hours a day. 

2. Partial Hospitalization Programs (PHPs)

Partial hospitalization programs (PHPs) offer intensive outpatient treatment. Participants spend their days at the treatment facility but live at home. 

These substance abuse treatment programs are best for people who can stay sober during their time away from treatment. 

PHPs for substance abuse offer a structured environment with outpatient psychiatric services. It’s an alternative to inpatient care for those who need something more flexible and/or affordable. 

These programs are more intense than IOPs. However, they still allow participants to live at home during treatment. 

Other Rehab Services Magellan Covers 

In addition to the treatment services listed above, Magellan Health also offers coverage for dual diagnosis treatment.

Many people with addiction also suffer from co-occurring mental health disorders. These include:

  • Anxiety
  • Depression
  • Post-traumatic stress disorder (PTSD)
  • Mood disorders like bipolar disorder

It’s important to address both issues concurrently. Relapse tends to be a higher risk for people in substance abuse treatment. This is particularly true if substance abuse is linked to a mental health disorder.

According to the Affordable Care Act (ACA), insurance providers must offer coverage for mental health treatment. This includes drug and alcohol rehab and treatments for any co-occurring mental health disorders. 

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How to Check Your Coverage

It’s important to check your healthcare coverage before committing to a treatment program. 

You can do this in one of three ways:

  1. Call the number on the back of your insurance card. You’ll be connected to a Magellan customer service representative. They’ll review the plan details with you and answer any questions.
  2. Login to Magellan’s member portal on their website. Here, you can read details about your plan and learn more about covered treatment services. 
  3. If you have a preferred treatment center in your area, contact them directly. They’ll help you determine how much you’ll pay out-of-pocket. 

Paying for Uncovered Rehab Costs 

Unfortunately, medical care and substance abuse treatment can be expensive, even with insurance coverage. Your provider usually doesn’t cover the cost of medical care until you meet deductibles and pay copays.

There are several tools available to alleviate the burden of out-of-pocket medical costs, like:

  • Requesting a loan from a bank or other lending institution
  • Borrowing money from close family members or friends  
  • Investing in a supplementary health insurance plan
  • Seeking federal, state, and/or government payment assistance
  • Selling property and/or possessions
  • Fundraising or “crowdfunding”
  • Paying for treatment with a credit card
  • Utilizing a treatment center’s payment plan
  • Scholarships or grants offered by treatment centers

People with substance use disorders (SUDs) should never let finances prevent them from getting the care they need. In the long run, feeding an addiction is often more expensive than addiction treatment. 

If you aren’t sure how to pay for treatment, contact your Magellan Health insurance provider or your preferred treatment provider for more information. They can answer any financial questions and direct you to the appropriate professionals. 

In most cases, Magellan Health customers have to pay a copay and meet out-of-pocket deductible obligations.

Call to find out how much your insurance will cover
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Resources

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  1. Solutions for Complex Healthcare.” Magellan Healthcare.  
  2. Health Plan Solutions.” Magellan Healthcare. 
  3. Pettinati, H. M., et al. “Inpatient vs Outpatient Treatment for Substance Dependence Revisited.” The Psychiatric Quarterly.
  4. Finney, J. W., et al. “The Effectiveness of Inpatient and Outpatient Treatment for Alcohol Abuse: The Need to Focus on Mediators and Moderators of Setting Effects.” Addiction (Abingdon, England), Dec. 1996. 
  5. McGovern, Mark P., et al. “Dual Diagnosis Capability in Mental Health and Addiction Treatment Services: An Assessment of Programs across Multiple State Systems.” Administration and Policy in Mental Health and Mental Health Services Research, Nov. 2012.
  6. Partial Hospitalization Coverage.” Medicare.gov.

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