Magellan Health Insurance for Drug and Alcohol Rehab

Plans offer different levels of coverage for services and types of treatment. The following substance use disorder 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 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 and intensive outpatient are 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.
• Individual and group therapy. Behavioral therapy is 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.¹ Dual diagnosis treatment helps people simultaneously recover from both their drug use disorder and mental illness.
• Halfway house care. Halfway homes 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.²

The types of substance misuse 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.³ 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.^4,5,6

Most plans with Magellan require that you 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.⁷ 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.

Magellan’s Approach to Substance Use Disorder Treatment

Magellan uses a comprehensive care management approach that supports the use of effective, evidence-based treatments for 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 misuse. Magellan also focuses on increasing provider education to ensure that the right medications are being used as part of addiction recovery plans.⁸

Magellan considers addiction treatment medications (also known as medication-assisted treatment or MAT) 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.⁸

Additionally, 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.⁸

What Is Magellan Healthcare?

Magellan Healthcare manages population health and serious mental illness, focusing on behavioral health, employee assistance program services, pharmacy management, and other specialty areas.⁹

Magellan has been a part of the behavioral health industry for more than 50 years.⁹ They support more than 6.2 million people in the commercial, Medicaid, Medicare and Medi-Cal populations.⁹

To get started with addiction treatment, you will need to verify your insurance benefits. We can review 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 long-lasting recovery.

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

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Sources

1. National Institute on Drug Abuse. (2024). Co-Occurring Disorders and Health Conditions.
2. Substance Abuse and Mental Health Services Administration. (2024). Methadone.
3. Healthcare.gov. (n.d.). Preauthorization.
4. Healthcare.gov. (n.d.). Copayment.
5. Healthcare.gov. (n.d.). Coinsurance.
6. Healthcare.gov. (n.d.). Deductible.
7. Centers for Medicare & Medicaid Services. (2017). What You Should Know About Provider Networks.
8. Magellan Healthcare. (n.d.). Behavioral Health.
9. Magellan Healthcare. (n.d.). Magellan Health Plan Solutions.