Magellan Drug & Alcohol Rehab Coverage
By The Orlando Recovery Center
Editor Theresa Valenzky
Last Updated: September 21, 2023
Orlando Recovery Center is a rehab facility that works with major insurance companies to make treatment accessible, including Magellan.
Cost may be a top priority when looking for an addiction treatment program. However, the costs of rehab are often covered by insurance. If you seek in-network treatment, you’ll likely have especially low out-of-pocket costs for addiction treatment. Orlando Recovery Center takes most types of insurance, including Magellan.
Magellan Provider Overview
Magellan Health is a health company based in Arizona, focusing on behavioral health, which includes substance abuse. The company was founded as a chain of psychiatric hospitals but has expanded throughout the years. Tens of millions of people have coverage through Magellan Health.
The focus on behavioral health is unique in the insurance industry. Many other health insurance providers will also partner with Magellan to fill in coverage gaps for mental health services.
Magellan Plans and Coverage Levels
Magellan provides plans through employers, companies and labor unions responsible for administering insurance to other organizations. These are known as third-party administrators. Insurance plans vary by state but usually are available in the following three categories:
- HMO: Health maintenance organization plans or HMO plans allow holders to get care from in-network providers. These are less expensive plans, but unless it’s an emergency, you might not be able to see a provider who’s out-of-network.
- POS: Point of service or POS plans give you more freedom to see your chosen providers. If you stay in-network, then your out-of-pocket costs will probably be lower. If you want to see a provider, not in-network, you’ll likely pay a higher copay. If you want to see a specialist, you must get a referral from your selected primary care provider.
- PPO: Preferred provider organizations or PPO plans generally cost more than other plans, but with that comes more freedom to choose where you receive care. You can stay in-network with lower copays, or you can go out-of-network and pay more to see a provider. You don’t need a referral to see specialty providers with a PPO.
How To Check Your Magellan Insurance Benefits
Before receiving addiction treatment, you should verify your benefits with Magellan. There are a couple of options available to go over your benefits.
- Reach out to Magellan directly
- Contact a Recovery Advocate from Orlando Recovery Center
- Fill out our insurance verification checker
Does Magellan Insurance Cover Drug and Alcohol Rehab?
Not only does Magellan’s insurance often cover drug and alcohol rehab, but this is what they specialize in. This company focuses on filling in gaps from other insurers to help more people gain access to behavioral health care, including rehab. The services and treatments that will be covered are based on your plan and chosen facility. There may be treatment centers that will only accept Magellan on a limited basis, for example. Your plan may require prior approval or preauthorization.
Do Treatment Centers Need To Be In-Network?
Most plans available through Magellan Health require you to see an in-network provider. In-network addiction treatment centers agree to provide services to members of an insurance plan for prices agreed on beforehand. If you were to see someone out-of-network or go to a rehab facility, not in-network, you would probably have to pay the full cost of services or a higher cost than you would otherwise. There are also some Magellan plans that limit how much time you can spend in a particular treatment program.
What Types of Addiction Treatment Does Magellan Cover?
Many types of addiction treatment may be covered by Magellan, including:
- Medical detox: These types of services help someone as they withdraw from drugs or alcohol.
- Inpatient/residential treatment: Inpatient rehab is intensive, and you live onsite at the rehab center during your initial treatment.
- Partial hospitalization programs: A PHP combines inpatient and outpatient rehab elements.
- Intensive outpatient: These programs are transitional for people going back to their daily lives.
- Outpatient treatment: Rehab on an outpatient basis includes flexibility and the ability to go home in the evenings.
- Medication-assisted treatment: Magellan may cover medication-based treatments for addiction and co-occurring psychiatric disorders.
- Dual diagnosis: It’s common for people with substance use disorders to have co-occurring mental health disorders. It’s a dual diagnosis when both are treated at the same time, and Magellan often covers this type of treatment.
Magellan Length of Treatment
The length of treatment you need for addiction will be based on many factors, including the facility, individualized treatment plans and medical needs. Most rehab stays in an inpatient facility are 30, 60 or 90 days, but can be longer. The length of time Magellan will cover is based on your plan, where you go for care if it’s in-network and the medical necessity of your treatment. You’ll need Magellan to preauthorize your rehab stay in almost all cases.
Magellan In-Network Coverage in Orlando
Orlando Recovery Center is available if you are looking for a rehab center that’s in-network with Magellan. We offer many evidence-based treatment programs in a safe, supportive setting. You can reach out to a Recovery Advocate to discuss your insurance benefits or Magellan directly to learn more about your coverage. You can also fill out our insurance verification tool.
Take the first step to your recovery today.
NIH National Library of Medicine. “Dual Diagnosis.” MedlinePlus, October 2, 2019. Accessed July 17, 2023.
McGovern, Mark P. Ph.D. And Carroll, Kathleen M. Ph.D. “Evidence-based practices for substance use disorders.” NIH National Library of Medicine, 2013. Accessed July 17, 2023.