Magellan is a health care company that has been in business since 1969. It started out as a chain of psychiatric facilities. Later, Magellan expanded into managed care and specialty health insurance.
The company’s health insurance offering is unique from other providers. Magellan health insurance focuses on behavioral health. Behavioral health encompasses mental health and substance use disorders.
General health insurance providers that do not have their own behavioral health benefits use Magellan. You may not be able to enroll in Magellan directly. But a vast majority of Americans get access through their primary insurer.
The Comprehensive Wellness Centers are proud to be in-network with Magellan Health. Below, we outline the types of addiction and mental health treatment services your insurance covers.
Magellan provides coverage for substance use disorder (SUD) treatments. The addiction type doesn’t matter. If you have a SUD diagnosis, Magellan will cover your treatment(s).
SUD treatments include those received in inpatient and outpatient settings. Partial hospitalization programs (PHPs) also qualify.
You can use in-network or out-of-network providers. However, the latter will cost you. You will pay higher insurance premiums for a plan covering out-of-network care.
For example, say you found a program, but it is not in-network with your insurance. You may have to pay a 40% or higher coinsurance fee. Seeing an in-network provider can halve that coinsurance to only 20% of the bill.
The exact amount of coinsurance you have to pay depends on your plan. Some plans may not require you to see an in-network provider at all. But you will have to make up for that in the form of higher premiums.
Magellan covers inpatient addiction treatment programs. They are also known as residential addiction treatment programs. That is because patients live in the drug rehab centers where they get treatment.
Services inpatient programs include, and Magellan health insurance, covers are:
Magellan also provides coverage for dual-diagnosis programs. These programs treat SUDs that co-occur with mental health disorders. For example, it is common for people with alcohol SUDs to also suffer from anxiety.
Magellan also provides benefits for outpatient services. This includes intensive outpatient programs (IOPs).
Patients enroll in outpatient services after discharge from a residential program. People with mild SUDs may only require outpatient treatment.
Services you can get Magellan insurance coverage for include therapy and 12-step programs. Do you need medication management as part of your treatment? Magellan may cover that, too.
One outpatient service some Magellan health policies do not cover is career services. For example, say you need help finding a job after rehab. Magellan will not cover the cost of job search assistance services.
PHPs sit somewhere between inpatient and outpatient treatments on the spectrum. Patients attend inpatient treatments at the facility during the day. Then, they return to their homes at night.
Magellan covers the same PHP services as inpatient and outpatient programs. That means you can receive benefits for detox, therapy, and more. But career counseling services may not qualify.
Magellan insurance also provides benefits for inpatient and outpatient mental health services. In some cases, you may need a diagnosis and a referral. Magellan may then provide coverage for the following mental health conditions:
Your insurance policy is the same for substance abuse and mental health disorders. The amount for addiction services is the same as the fee for mental health treatments.
In some cases, you may have to see an in-network provider. You may also have to receive a diagnosis and a referral to get coverage for your treatment. Both of these factors depend on the plan you enroll in.
Inpatient mental health programs are similar to inpatient services for SUDs. Patients live at the treatment facility while receiving care. You can enroll in one of these programs whether or not you have a SUD.
Treatments for mental health conditions include therapy and medication. Group therapy is especially helpful for some people. Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) are also available.
Medication benefits also come with Magellan health plans. Magellan offers more coverage for generics than brand-name drugs. This includes medication you receive in an inpatient setting.
Magellan also covers outpatient mental health services. This includes intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs).
The treatments used in these settings are identical to those for inpatient programs. Magellan will also cover virtual therapy. That is good news since patients often incorporate teletherapy into their outpatient programs.
You can also get coverage for medication. The exact amount you pay will depend on your insurance policy tier. In some cases, you can pay nothing for virtual therapy once you meet your deductible.
Magellan specializes in insurance benefits for people with addiction and mental health disorders. Coverage extends to inpatient and outpatient services. Working with an in-network provider can decrease your costs for care further.
Are you searching for a mental health and substance abuse treatment program that accepts your insurance? Comprehensive Wellness Centers has multiple locations in South Florida. And all of them accept Magellan health insurance.
Verify your insurance today to learn more about which of our services your policy covers.