Magellan Insurance Detox & Rehab Benefits Guide

Magellan Insurance Detox & Rehab Benefits Guide

Magellan Health is a private health insurance company. It provides health insurance plans through employers, labor unions, and companies that administer insurance for other organizations (third-party administrators), and also works in conjunction with different government and military agencies.1 , 2  Recognized as a Fortune 500 company, Magellan provides health insurance coverage to approximately 55 million people.
This page will help you understand more about your Magellan insurance benefits and explain more about Magellan’s detox and drug rehab coverage so you can use it to access treatment for substance use disorders. Topics that will be discussed in more detail will include:

  • What kind of Magellan Insurance plans may be available?
  • Does health insurance cover detox with most plans, and what other treatment options may be included with Magellan Insurance healthcare coverage?
  • How to check your Magellan Insurance benefits.
  • Information about detox and treatment at American Addiction Centers facilities and the benefits of attending these facilities.

Does Magellan Insurance Cover Detox?

When you have a substance use disorder and make the decision to seek treatment, you may have financial concerns. Many people ask whether detox is covered by insurance and want to learn more about their insurance coverage for rehab. Magellan drug rehab coverage must be seen as medically necessary to be approved. Services may include:

  • Inpatient treatment, where you stay at a facility for the duration of treatment.3, 9, 10, 11 Detox in this setting means you have medical and counseling staff who offer monitoring and support around-the-clock to ensure your safety and comfort. Treatment usually involves an intense combination of group and individual therapy.
  • Partial hospitalization programs (PHPs) are a step down from hospitalization. You live at home while receiving up to 8 hours a day of intensive counseling, support, and monitoring.3 ), 9  Detox in a PHP offers more attention than you’d normally receive in an outpatient setting without having to stay in an inpatient facility.
  • Intensive outpatient programs provide at least 3 hours of therapy several days per week, gradually stepping down to traditional outpatient care.3 , 9, 10 This type of treatment may be more effective if you have a less severe case of substance abuse—perhaps you haven’t been using substances for long, or the substances you use don’t have established withdrawal syndromes.
  • Outpatient therapy allows people to receive less intensive treatment while having the freedom to live at home and attend work and/or school.3 , 9 , 10 , 11 Detox can occur in this setting for people who may experience less severe withdrawal. In general, though, outpatient services are better suited for therapy after you’ve completed detox or inpatient rehab.10
  • Medication-assisted treatment (MAT), in which medications are used to ease the symptoms of withdrawal.3, 10, 11  Once detox has been completed, MAT can be used to help manage cravings or address mental health symptoms to support your long-term recovery. Some examples of drugs used in MAT include methadone, suboxone, Antabuse (disulfiram), and naltrexone.10 
  • Therapy can be especially helpful in addressing the underlying issues that contribute to your substance use disorder.9, 10 Individual, group, and family therapy sessions can teach you about coping skills, how to avoid relapse, how to communicate more effectively, and how to improve various areas of your life that may have been affected by your addiction, including your physical health, mental health, social life, employment, and legal issues.10

Your Magellan rehab insurance coverage depends on the specific plan that you have, so it is important to check with your provider to confirm that your treatment will be covered.3 Some services may have limits or require prior authorization.10 If you have a family member or dependent in need of substance abuse treatment, they will also be covered under the insurance plan and will be eligible to receive these services.

How to Check Your Magellan Insurance Benefits

Before you begin looking for a detox or treatment provider, it is a good idea to check your insurance benefits. You can do this in several ways. By calling the phone number on the back of your card, you’ll be put in touch with a customer service representative who can answer any questions you may have and explain which detox and rehab treatment services Magellan will cover under your plan. You can also refer to the member handbook or visit this site, where you can access the online portal to find out what is covered under your specific plan.

 

Types of Magellan Insurance Plans

Magellan Insurance is available in many states in the United States; plans it offers may vary by state.2 (geographic reach) Healthcare plans available through Magellan Insurance fall into 3 categories:

  • Health maintenance organization (HMO) plans, where you can receive care only from providers who are in-network. This plan generally costs less than any other type of plan.4  You may not be able to see an out-of-network provider unless it is an emergency.4  Magellan out-of-state coverage may be limited with this type of plan.
  • Point-of-service (POS) plans offer more freedom to see a provider of your choosing.4  In-network providers are available at a lower cost but you are also allowed to see out-of-network providers as long as you’re willing to pay higher copays.4 ) Before seeing a specialist, you’ll need to obtain a referral from your primary care physician.
  • Preferred provider organization (PPO) plans generally cost more than any other type of plan, but offer the most freedom of choice.4 Like a POS plan, you can either see providers in the network and pay lower copays, or go to out-of-network providers who will cost more to see.4  However, with a PPO plan, you will not need a referral to see a specialist.4

For more information about the plans that are available in your state, you can visit this website.

Magellan and Medicare

Medicare is a government program that provides health insurance to people who are over age 65 or people with certain disabilities.5  Magellan Insurance works in conjunction with Medicare to provide Medicare Advantage plans.6 (p1) These provide hospital (Part A), medical (Part B), and, typically, prescription (Part D) coverage all in one plan.7 You may be required to get referrals for specialist visits and see a provider who is in-network, since not all plans offer coverage for out-of-network providers.

Magellan Complete Care plans are available for residents of certain states who are eligible for both Medicaid and Medicare.8 This plan strives to provide integrated care to meet all the needs of its members by using all of the resources available.8 (about Magellan Complete Care, what we do)

Detox at American Addiction Centers

American Addiction Centers (AAC) is one of the nation’s foremost providers of quality and evidence-based detox and rehab services for people with substance use disorders.12  It accepts many health insurance plans, including Magellan Insurance, and maintains an in-network status with a wide range of other insurance plans.12 (see if you’re covered)

With American Addiction Centers facilities all around the country, it’s easy to access detox and rehab services no matter where you are with the assurance that you’ll receive tailored, effective, and cutting-edge treatments.13 , 14  All treatment begins with an effective medical detox for which you’ll have support from a full medical staff to ensure your safety.14 

Your treatment plan at ACC focuses on more than just substance use; it also addresses any other concerns you may face, including physical and mental health and social, legal, occupational, and family issues, to help you recover successfully.14  For more information about detox and rehab at American Addiction Centers, our confidential helpline is available 24/7 at 1-888-935-1318.

 

  1. Magellan Health. (2020). About us.
  2. (2020). Magellan Health, Inc.
  3. Magellan Healthcare. (2019). Provider handbook supplement for Blue Shield of California (BSC).
  4. Healthcare.gov. Health insurance plan and network types: HMOs, PPOs, and more.
  5. Medicare.gov. What’s Medicare?
  6. Magellan Health. (2018). AvMed quick reference guide.
  7. gov. How do Medicare Advantage Plans work?
  8. Magellan Health. (2020). About Magellan complete care.
  9. Magellan Complete Care of Arizona. (2020). Member handbook.
  10. Magellan Complete Care of Florida. (2020). Member handbook.
  11. Magellan Complete Care of Virginia. (2020). Benefits and services.
  12. American Addiction Centers. (2020). American Addiction Centers.
  13. American Addiction Centers. (2020). Treatment centers.
  14. American Addiction Centers. (2020). Substance abuse treatment services.