What is Magellan Health?
Magellan Health is a healthcare company that focuses on behavioral health, employee assistance program services, pharmacy management, and other healthcare specialties.1 A Fortune 500 company, Magellan serves 1 in every 10 Americans and employs over 10,700 people around the United States.1,2 Magellan provides health insurance to people throughout the country and is committed to helping people receive the care they need, when they need it, including those who wish to safely recover from substance use disorder. If Magellan is your health insurance provider, you can receive treatment for drug and alcohol addiction, though coverage for these services varies, depending on your plan.
Magellan Health has a focus on behavioral health, which sets it apart from its competitors in the healthcare insurance industry.2 If you or your loved one are ready to enter treatment for drug or alcohol addiction, most rehab centers can check your insurance coverage on the phone to determine what is covered by your Magellan plan. Simply call the rehab center with your insurance information, and the admissions navigator can verify your insurance for you while you’re on the phone.
Alternatively, you can call the number on the back of your insurance card to speak with a Magellan customer service representative who can walk you through the details of your plan.
What will Magellan Health insurance cover?
As a Magellan Health customer, you can rest assured that at least some of your drug and alcohol addiction treatment services will be covered by your plan. Magellan covers treatment for most substance use disorders and co-occurring disorders, such as depression, anxiety, and PTSD. That said, the services and treatments available will depend on the facility you attend and what is covered by your insurance policy.
Some treatment centers that accept Magellan may only offer drug and alcohol detox services while others offer treatment including individual and group counseling.
Addiction Treatments Covered by Magellan Health Insurance
Magellan health insurance plans offer different levels of coverage for services and types of treatment. Many Magellan plans require you to attend a counseling session to determine your medical needs for addiction treatment before coverage kicks in.3 After this confidential, private counseling session, your Magellan Health insurance plans may cover at least some of the expenses for the following treatment services:3
- Magellan Health for Medical detox: Detox helps you safely and more comfortably withdraw from drugs and alcohol. This may include the use of medications and almost always includes 24/7 medical supervision from trained, understanding professionals.
- Magellan Health for Inpatient treatment: Inpatient drug and alcohol treatment programs offer 24-hour care and supervision and involve living on-site at the rehab facility. Your addiction and other mental health conditions will be addressed by trained medical professionals, and you will attend individual and group therapies while in treatment.
- Magellan Health for Outpatient treatment: Outpatient programs allow you to live at home while visiting the treatment center for a set number of hours per week. Some rehab facilities offer room and board to clients in outpatient programs who are not from the local area. Partial hospitalization programs include medical care and supervision; other outpatient programs usually do not.
- Magellan Health for Partial hospitalization programs (PHPs): Partial hospitalization programs are intensive outpatient programs that involve spending your days at the treatment facility while living at home. This is best for people who can stay sober during the evenings/nights and weekends when not attending treatment. You must be committed to attending treatment during the weekdays.
- Magellan Health for Intensive outpatient programs (IOPs): Intensive outpatient programs require you to attend treatment approximately 3-5 evenings a week. You can live at home and work during the days and attend treatment and counseling sessions in the evenings. This may involve individual and group therapies.
- Magellan Health for Dual diagnosis treatment: Almost half of the individuals with substance use disorders have a mental health disorder, such as anxiety, depression, PTSD, or a mood disorder.4 Dual diagnosis treatment helps address both addiction and any mental health conditions you have at the same time to optimize treatment outcomes.
Does Magellan Health Insurance Cover Mental Health Facilities?
Substance use disorder and mental health conditions often go hand-in-hand. This is known as co-occurring disorders or dual diagnoses. According to the 2016 National Survey on Drug Use and Health, more than 8 million adults aged 18 or older had mental illness and substance use disorder.5
Under the Affordable Care Act (ACA), insurance providers are required to provide coverage for mental health care and treatment.6 Both co-occurring disorder treatment and stand-alone rehab for drug and alcohol addiction fall under this mandate. Magellan is considered to be a leader in providing support for behavioral health, including addiction and other mental health conditions. Most Magellan plans cover mental health treatment while in rehab to ensure improved quality of life and outcomes.7
Treating mental health conditions at the same time as substance use disorders typically results in better treatment outcomes.4, what are the treatments for Mental health conditions and addiction often impact one another, and treating one but not the other is generally not as effective. Most rehab centers offer dual-diagnosis therapy and other services.
How Long Does Magellan Health Insurance Cover Inpatient Drug Rehab?
The duration (length) of treatment covered under Magellan Health Services insurance plans depends on your specific plan. In many cases, it also depends on the type of treatment that has been deemed medically necessary after you undergo a private, confidential counseling session and receive a referral for addiction treatment. The length of drug and alcohol addiction treatment covered varies, depending on your plan and your specific treatment care needs.
Longer treatment times generally lead to better outcomes for addiction treatment.8 In most cases, a longer stay in rehab leads to fewer instances of relapse, and better rates for long-term sobriety. Research shows that 3 to 6 months in treatment programs followed by structured continuing care—including counseling and outpatient treatment programs—is associated with better treatment outcomes for individuals with substance use disorder.8
To get a better understanding of what your Magellan Health plan covers and the duration of treatment covered, you can log in to the Magellan member portal to read about the details of your plan. Alternatively, you can call the number on the back of your insurance card to speak directly with a Magellan customer service representative who can go over the details with you in regards to what is covered and for how long for drug and alcohol treatment/rehab.
What if my Magellan Health policy does not cover alcohol and drug treatment programs?
As a Magellan insurance policyholder, at least some of your drug and alcohol addiction treatment will be covered by your insurance plan. Even if insurance doesn’t cover 100% of your treatment services, it’s important to not let finances be a barrier to seeking treatment. What’s most important is your sobriety and recovery. There’s no doubt about it—getting treatment saves lives.
Many drug and alcohol treatment centers throughout the United States accept Magellan insurance to provide coverage for drug and alcohol treatment. If Magellan doesn’t cover all of the costs, there are other ways to finance your treatment, including:
- Crowdfunding (asking family and friends for support).
- Federal, state, and local government programs.
- Financing from banks and other financial institutions.
- Payment plans through the rehab facility that allow you to pay back your costs over time.
- Scholarships and grants offered by rehab centers.
Fortunately, your Magellan insurance should cover a significant percentage of your treatment costs, though you may need to meet a deductible before coverage kicks in and be responsible for any copays for treatments/services you receive, depending on your specific plan.
Magellan Health In-Network vs. Out of Network Inpatient Drug Rehab Centers
In-network drug and alcohol treatment centers have an agreement with Magellan to offer treatment at a lower rate than other treatment providers. In-network facilities work directly with Magellan to cover many treatment costs.
Out-of-network facilities do not have an agreement with Magellan and therefore are not able to offer treatment at a lower rate. This typically means you will be responsible for more, if not all, of your treatment costs.
There can be significant cost differences in selecting an out-of-network vs in-network facility. Whenever possible, choose an in-network facility to keep your costs down. If you choose an out-of-network provider, you will likely have to do more work to get insurance approval for treatment services, and coverage is not always guaranteed. Magellan may cover treatment costs for out-of-network providers in rare circumstances, such as for a veteran who needs to seek treatment at a veteran-focused facility and is unable to find one in-network.
Selecting a treatment facility that is in-network with Magellan will keep your out-of-pocket costs lower, allowing you to focus on what matters—your recovery and sobriety.
How to Check Magellan Health Insurance Coverage for Drug Treatment?
Drug and alcohol treatment can be expensive. Having insurance coverage makes it easier to manage and allows you to focus on your health, well-being, and sobriety.
Before you make your decision on which treatment facility to attend, check your Magellan health insurance benefits. This ensures you have a full understanding of what is covered and what you are responsible for paying for before you enter treatment. You may have to meet a deductible before coverage kicks in, for example. There are a number of ways to check your insurance coverage for addiction treatment:
- Call the number on the back of your insurance card. This will connect you with a Magellan customer service representative who can go over the details of your plan with you while you’re on the phone.
- Login to Magellan’s member portal on their website to read the details about your plan and fully understand what drug and alcohol treatment services are covered by your plan, deductibles, copays, and any other out-of-pocket expenses.
- Call an admissions navigator at American Addiction Centers. Call our helpline at to speak to an admissions specialist who can quickly check your benefits while you’re on the phone and answer any questions you may have.
If you prefer, you can complete the form below to enter your information. You will get immediate results to learn if the rehab center you are considering is in-network with Magellan Health.