(Please note: Rehabs.com strives to provide you with the most updated information on each carriers' addiction insurance coverage but policy changes and errors do occur. Please check with your insurance carrier directly to confirm coverage levels. Rehabs.com is an informational site only and is not affiliated or sponsored by Magellan.)
Does Magellan Health Services Cover Detox Services?
"It is usually necessary to get the detox and treatment approved before entering into any program..."If you have a health insurance plan from Magellan Health Services that includes Magellan LifeResources, you should be covered for most types of substance abuse treatment programs, including any necessary detoxification period. However, it is usually necessary to get the detox and treatment approved before entering into any program, or else you risk having your coverage denied.
Does Magellan Health Services Cover Rehab?
Any Magellan Health Services plan that includes LifeResources coverage will pay for at least part of any drug or alcohol rehabilitation program that has been deemed necessary by its Employee Assistance Program. Therefore, the first step is to contact one of these counselors and receive a treatment referral.
Addiction Treatment Length Magellan Health Services Will Cover
The duration or length of addiction treatment covered under Magellan Health Services insurance plans depends on the type of treatment deemed necessary after a person undergoes confidential, private counseling and receives a referral for discreet treatment. The length covered is as follows:
- Up to two 28-day treatments per year at an inpatient facility
- Coverage all costs up to $3,500 per year for outpatient facilities
Specialty Alcohol and Drug Treatment Through Magellan Health Services
If it is determined that you need treatment at an executive or luxury addiction facility, this might be covered under your Magellan Health Services plan, provided you get it pre-approved. Typically, the upscale amenities and services, such as spa treatment and gourmet meals, are not deemed medically necessary, which may mean higher out-of-pocket expenses for you. So, even if you need treatment at an exclusive facility, you should contact your Employee Assistance Program to find a facility with the amenities needed to make your rehab successful.
Insurance for Inpatient Addiction Treatment vs. Outpatient
Your insurance coverage varies depending on if you need residential inpatient treatment or outpatient treatment and whether you choose a provider in Magellan's approved network. For inpatient treatment at a network provider, you will be covered for 100 percent of the costs for the approved duration of your treatment. For out-of-network inpatient facilities, Magellan will cover 50 percent of the total costs.
"Your insurance coverage varies depending on if you need residential inpatient treatment or outpatient treatment and whether you choose a provider in Magellan's approved network. "
For outpatient treatment, there is a always a 10 percent copay, after which Magellan covers 90 percent of the costs at a network facility and 50 percent of the fees charged by out-of-network treatment centers.
How to Cover What Insurance Won't
In most cases, you will likely have to pay for at least some part of your addiction treatment, so it's important to prepare for this before being admitted into a treatment program. You should find a facility that offers the ability to pay in installments or will work with you to develop a payment plan. The costs of your treatment could end up being several thousand dollars, so you need to make sure you have some way to pay off your part of the rehab costs.
Verifying Coverage and Finding the Best Treatment
Determining what is actually covered under your insurance plan can be quite frustrating and time-consuming, especially when searching for the right treatment facility that perfectly suits your specific needs. According to the Principles of Drug Addiction Treatment produced by the National Institute on Drug Abuse, choosing the right treatment is the most important determining factor in successfully overcoming drug or alcohol addiction. Therefore, it is of the utmost importance that you find the right rehab facility that is covered by your insurance plan so that you or your loved one can get the quality addiction treatment needed.
If you need help finding a treatment facility or understanding what is covered under your insurance plan, don't hesitate to call your insurance company to learn the details of your specific plan.