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How to Pay for Drug Rehab With Magellan Insurance?

Last Updated: October 25, 2019

Magellan Health is a Fortune 500 managed healthcare company that focuses on behavioral health, employee assistance program services, pharmacy management, and various other specialty areas. Based out of Scottsdale, Arizona, Magellan is home to about 10,700 employees and serves an estimated 1 in 10 Americans.1,2

Magellan is committed to helping people receive the care they need to safely recover from substance use disorders. People who are covered by Magellan can receive medical treatment and therapy for mental health disorders and substance abuse, though coverage for these services will vary based on their plan.

American Addiction Centers accepts Magellan Health—get more information about payment options and confirm your insurance benefits.

Will Magellan Insurance Cover My Addiction Treatment?

Psychologist having session with her patient in officeMost likely, yes. Magellan covers treatment for most drug and alcohol use disorders as well as treatment of co-occurring disorders such as anxiety and depression.

However, the services and treatments available will vary depending on the plan and facility. For instance, some treatment centers that accept Magellan may only offer drug and alcohol detox services, while other treatment centers may only offer outpatient programs and group therapy.

Nearly all drug rehab centers offer a range of therapies to treat and help people recover from any addiction type.

Addictions that may be covered by Magellan include:

  • Alcohol.
  • Opioids and opiates (heroin, oxycodone, hydrocodone, codeine, morphine).
  • Cocaine.
  • Methamphetamine.
  • Marijuana.
  • Hallucinogens.
  • Prescription drugs (i.e., benzodiazepines, ADHD medications, sleep aids).

Which Addiction Treatments Are Covered by Magellan Insurance?

Plans offer different levels of coverage for services and types of treatment. The following substance abuse treatment services may be covered under your plan with Magellan.

  • Detox. Detoxification helps you safely withdraw from drugs and alcohol and can include medications and medical supervision.
  • Inpatient. Inpatient programs offer 24-hour medical care and supervision for those experiencing severe and acute symptoms of withdrawal. They are capable of addressing significant mental health issues and/or other conditions that require relatively intensive medical attention.
  • Residential. Residential programs allow you to live at the treatment facility and offer a structured daily routine comprised of individual and group therapy sessions.
  • Outpatient. Partial hospitalization, intensive outpatient, and outpatient therapy are all types of outpatient programs that typically allow you to live at home while visiting the treatment center for a set number of hours every week. However, American Addiction Centers provides room and board to clients in its intensive outpatient program and partial hospitalization programs who are not from the local area. Partial hospitalization includes medical care and supervision, whereas the others may not include medical care.
  • Individual and group therapy. Therapies are offered on an individual and group basis to help you modify negative behaviors and thoughts related to addiction and learn new skills that can help you stay abstinent from drugs and alcohol.
  • Dual diagnosis treatment. Nearly half of all people with substance use disorders are also diagnosed with a mental health disorder and vice versa.3 Dual diagnosis treatment helps people simultaneously recover from both their drug use disorder and mental illness.
  • Halfway house care. Halfway houses or sober living facilities are a transitional option for people who have completed a rehab program. They offer a structured, drug-free environment for people to continue to receive support while they adjust to sobriety.
  • Methadone treatment. Methadone helps to minimize withdrawal and blocks the effects of other opioids to encourage abstinence in people recovering from opioid dependence.4

Verify Your Insurance Coverage

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1Insurance Disclaimer: American Addiction Centers will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. Please note, this is only a quote of benefits and/or authorization. We cannot guarantee payment or verification eligibility as conveyed by your health insurance provider will be accurate and complete. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at time of service. Your health insurance company will only pay for services that it determines to be “reasonable and necessary.” American Addiction Centers will make every effort to have all services preauthorized by your health insurance company. If your health insurance company determines that a particular service is not reasonable and necessary, or that a particular service is not covered under your plan, your insurer will deny payment for that service and it will become your responsibility.

How Does Magellan Insurance Coverage Work for Rehab?

Preauthorization is when your health insurer decides that a healthcare service or treatment is medically necessary.

The types of substance abuse services and the amount of coverage you receive from Magellan will vary depending on your plan and the state where you live.

When you are admitted to a program, you may need a preauthorization within the first 48 hours of treatment. However, some plans may require preauthorization before admission. If you do not obtain a preauthorization, Magellan may not cover your treatment.

Also known as prior authorization or prior approval, preauthorization is when your health insurer decides that a healthcare service or treatment is medically necessary.5 Preauthorization may or may not be required for outpatient services.

Some plans may also require you to pay a copayment or coinsurance, or meet a certain deductible. A copayment is a fixed amount you pay for a healthcare service prior to or after you’ve met your deductible. Coinsurance is a percentage of a healthcare service cost you pay after paying the deductible. A deductible is the cumulative amount you must pay for certain services before your insurance will begin to provide coverage.6,7,8

Most plans with Magellan require you to receive addiction treatment from an in-network provider, which is a provider that has agreed to provide services to a plan’s members for agreed-upon prices.9 You may end up paying the full cost or a higher cost for treatment when receiving treatment from an out-of-network provider. Some plans also limit the amount of time you spend in a certain treatment program, though these limits vary based on the plan.

Will My Employer Find Out?

Under federal law, insurance and treatment providers cannot disclose to someone outside the rehab center that a person is receiving treatment for a substance use disorder or mental illness. Your personal patient records are strictly confidential, and your employer will not learn about your substance use disorder and treatment from Magellan or your treatment center. There are exceptions to this law, however, such as a court order or a disclosure for emergency treatment, research, or an audit or program evaluation.

Magellan’s Approach to Substance Abuse Treatment

 Magellan considers medication-assisted treatment a best practice for the treatment of opioid and alcohol use disorders.

Magellan uses a comprehensive care management approach that supports the use of effective, evidence-based treatments for addiction and substance use disorders. Magellan focuses on offering clinically appropriate interventions and personalized substance use coaching and aims to help all patients achieve healthy, independent lifestyles after recovering from substance abuse. Magellan also focuses on increasing provider education to ensure that the right medications are being used as part of substance abuse recovery plans.10

Magellan considers medication-assisted treatment a best practice for the treatment of opioid and alcohol use disorders, as well as office-based opioid treatment for those who must also manage busy personal lives while in recovery.10

Finally, the diagnosis and treatment of co-occurring mental health disorders is a key focus for Magellan, since roughly 45% of people with a substance use disorder also suffer from mental illness.10

How Do I Get Started?

To get started with addiction treatment, you will need to verify your insurance benefits. We can discuss your benefits and help you choose a treatment center that covers your addiction type and the services you need to recover from your substance use disorder. We understand that each person has different coverage and individual circumstances, and we will work with you to find the best possible treatment option.

To verify your insurance benefits through Magellan, you may call one of our admissions navigators, use our live chat feature, or use the benefits verification form on this page. Everything will remain confidential. Our goal is to help you find a drug rehab center that accepts Magellan and that covers the services and treatments you need to experience a safe and fulfilling long-lasting recovery.

Contact us today at 888-971-2494 to learn more about using Magellan insurance to receive treatment with American Addiction Centers.

Sources

  1. Fortune 500. (n.a.). Magellan health.
  2. Magellan Health. (n.a.). About us.
  3. National Institute on Drug Abuse. (2018). Common comorbidities with substance use disorders.
  4. Substance Abuse and Mental Health Services Administration. (2019). Methadone.
  5. Healthcare.gov. (n.a.). Preauthorization.
  6. Healthcare.gov. (n.a.). Coinsurance.
  7. Healthcare.gov. (n.a.). Copayment.
  8. Healthcare.gov. (n.a.). Deductible.
  9. Centers for Medicare & Medicaid Services. (2017). What You Should Know About Provider Networks.
  10. Magellan Healthcare. (2017). Overcoming substance use disorders
Last Updated on October 25, 2019
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About the editor
Dan Wagener
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Dan Wagener is a Senior Web Content Editor at American Addiction Centers.

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