In the past, people suffering from substance abuse had difficulties receiving coverage for stints in substance abuse treatment centers. Many plans that did provide coverage often came with unique stipulations, including clauses that eliminated future coverage if clients left treatment early or had other challenges.
Older insurance providers and outdated coverage models didn’t fit the model required to provide efficient coverage for specific clients, leading to a large coverage gap. However, when one organization falls short in business, an opportunity arises for newer companies with the right plan in place.
Organizations like Magellan Health focus specifically on substance abuse and behavioral health, catering to individuals who require mental health and rehab services. Magellan Health is headquartered in Scottsdale, Arizona, has nearly 10,000 employees, and provides coverage for millions of Americans.
Magellan offers multiple coverage plans, including PPO, HMO, and POS services. In addition, they also provide reimbursement accounts, health savings plans, individual plans, and Medicare.
Even organizations that deal specifically with mental health and substance abuse have specific terms and conditions clients and rehab sites must meet for adequate coverage. If you’ve been thinking about getting Magellan Insurance, you might be wondering what a Magellan-approved rehab is? pocket
What Is a Magellan Approved Rehab?
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A Magellan-approved rehab is defined as a treatment facility that accepts Magellan insurance. There isn’t a specific set of requirements for a rehab to be established as a “Magellan-approved” rehab, but these are some of the characteristics of programs that Magellan covers:
- Supervised drug and alcohol detox (medically-assisted detox)
- Addiction treatment medications
- Treatment center residencies
- Dual-diagnosis treatment
- Transitional care
- Monitored drug and alcohol detox
- Addiction recovery care
- One-on-one counseling
- Coping mechanisms
- Aftercare services
A rehab facility that Magellan covers will display some if not all of the services listed above. Many people ask about specific treatment options. The good news is that Magellan isn’t limited to the services covered by their program.
They even have multiple policies to accommodate nearly every level of care. Magellan most likely has an appropriate plan depending on the severity of your case and the type of treatment you require.
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Magellan Substance Abuse Treatment Options
These are all services listed by Magellan as services that are covered during any treatment stay.
Detox
Many clients need detox before beginning the therapy portion of rehab. During detox, clients will eliminate all traces of their substance of choice from their system. This period may include a painful withdrawal period, and detox provides a safe location for them to endure this process.
Inpatient Rehab
Inpatient rehab consists of a 30, 60, or 90-day residency at a substance abuse treatment facility. During treatment, clients will undergo various other mental health and substance abuse counseling sessions and other activities, including group recovery meetings.
Partial Hospitalization (PHP)
A partial hospitalization program allows clients to remain living at home while participating in rehab during the day. This is the last level of care before full inpatient rehab.
Intensive Outpatient
Intensive outpatient is an outpatient program that’s more intense than the regular outpatient regimen. Clients can live at home, but they’re usually instructed to attend treatment for at least 20 hours per week.
Outpatient Treatment
Outpatient treatment is when clients remain living at home and attend therapy sessions for at least 10 hours per week. Clients must stay sober and could be required to submit to random drug testing.
Can Magellan Insurance Cover Residential Treatment?
Magellan insurance can provide coverage for residential or inpatient rehab. Several types of plans are available for clients depending on the level of care they require. However, some plans may cost more than others, depending on the services.
Copays and levels of coverage fluctuate depending on the plan, so it’s essential to be clear on the exact level of coverage provided for you when you sign up.
Is Medication-Assisted Treatment Possible with Magellan?
Magellan insurance has an initiative that places a heavy focus on the use of medication-assisted treatment. Their goal is to increase the availability of medications like buprenorphine, naltrexone, and other prescriptions that provide relief from opioid abuse disorder.
Features of Approved Magellan Rehab Programs
Magellan rehab programs have various programs and different forms of therapy available. However, some of the most common characteristics include:
- The availability of medication-assisted treatment
- Access to medically assisted detox
- Heavy emphasis placed on aftercare services
- Access to multiple forms of treatment, including cognitive behavioral therapy, dual-diagnosis treatment, and other forms of therapy.
In addition, each rehab program should also provide a variety of different care levels, including inpatient treatment options, outpatient programs, and other programs for clients to choose from.
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Will My Magellan Policy Cover Medical Detox
Your Magellan policy could cover medical detox if you have the right one. However, not every policy is the same, as multiple plans are available with different coverage levels, program availability, copays, deductibles, and more.
If you have questions regarding your policy, you must contact your agent. They’re equipped to provide you with the specifics regarding your policy and levels of coverage, including treatment options available to you.
Does Magellan Cover Out of State Rehab Centers?
Magellan provides coverage in multiple states. They likely have a plan that covers treatment if you’re interested in an out-of-state option.
However, it would help if you were 100% sure of your coverage and policy options before leaving for out-of-state rehab. All questions should be answered beforehand to ensure there are no setbacks when you arrive for treatment.
Can I Get Dual-Diagnosis Treatment with Magellan?
Magellan does have policies that specifically cover dual-diagnosis treatment. However, you must choose the correct policy that includes this form of therapy in your coverage options.
If you have a policy that doesn’t cover dual-diagnosis, you could be denied this form of treatment at the rehab facility or be forced to accept a different form of therapy included in your plan. When you need dual-diagnosis treatment specifically, it’s essential to let your agent know this so they can provide you with the most appropriate policy that addresses your needs.
Prescription Medication Coverage with Magellan
Magellan insurance does cover certain types of prescriptions. The company has what’s known as a formulary, which lists all the covered medications.
It would help familiarize yourself with the formulary to understand whether the medications you require are covered. If you’re prescribed something that isn’t covered, it may be possible for your physician to prescribe you a generic or something similar that is covered by your plan.
Does Magellan Cover Aftercare Services or Sober Living?
In some cases, Magellan insurances cover aftercare services or sober living facilities. This is known as a long-term structured residence, but you must have the right policy.
Magellan may cover a portion of your stay there or the total amount, depending on your situation. Be sure to speak with your agent regarding these coverage options long before it’s time for you to exit rehab and enter a sober living home.
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Find Lasting Recovery with Magellan Coverage at Emerald Isle Health & Recovery
At Emerald Isle Health & Recovery, we believe that lasting recovery is possible with the right attitude and team by your side. In conjunction with healthcare providers like Magellan, we help thousands of clients overcome their substance abuse disorder and enter a lifetime of recovery every year.
We believe in you, and you must believe in yourself. With a positive attitude and custom treatment plan, our experienced care staff will help you experience your recovery goals and get you back to a normal life.
If you or someone you know is struggling with substance abuse or alcohol use disorder, don’t wait another day. Contact a member of our compassionate admissions staff to learn about insurance and the registration process.
Magellan Insurance FAQs
Does Magellan Insurance cover rehab for specific types of substance abuse?
No, at Magellan, there’s no discrimination regarding any client’s type of substance abuse issue. Coverage is provided to all clients, no matter the specifics. This includes opioids, cocaine, alcohol, methamphetamines, marijuana, LSD, and all other substances, narcotic or otherwise.
Will Magellan cover detox and allow me to transfer directly to inpatient rehab?
If you have the proper coverage and policy, the goal is to get you through detox and immediately into a treatment program with no lag time. Being admitted into some type of rehab program is critical for your recovery, whether inpatient, outpatient, partial hospitalization, or any other form of treatment. This gives you the best odds of long-term recovery, which is the overall goal for any client.
Does Magellan cover prescriptions that aren’t related to medication-assisted treatment?
If your prescriptions are a part of your substance abuse treatment therapy, they may be partially or fully covered. For example, in the case of dual diagnosis treatment, prescriptions written for bipolar disorder combined with substance abuse disorder would be a part of your rehab treatment. They would be covered in some form (assuming you have the right policy).
