In-Network Provider With Magellan Health: What It Means For You

Magellan In-Network Provider (HMO) for Addiction Treatment

Wednesday, July 1, 2020 | By Cooper Samp

Do you have an HMO plan with Magellan Health and therefore need to find an in-network provider?

Do you have a PPO plan with Magellan Health but want to spend the least amount of money in out of pocket costs?

Coalition Recovery can help! We are in-network with Magellan Health and can offer treatment services to any Magellan Health Plan. This means we also provide the most cost-effective care around.

Coalition Recovery is currently in-network with Magellan Insurance policies; meaning if you are actively covered through Magellan health, we provide the most cost-effective treatment in the Florida area. 

Being an in-network provider with Magellan Health means we have met their criteria and standards for optimal addiction treatment. Since Magellan is confident in our program, our facility is a part of their 77,000 mental health partners in the U.S.

Being In-Network: Why Does It Matter?

In-Network facilities offer service to any plan under the healthcare provider. Therefore, if you have healthcare coverage from Magellan Health, you are able to attend any health facility that is in-network. If you wish to receive services outside of their health partners, you will have to have out-of-network benefits (PPO plans) or pay out of pocket.

Also, if you have out-of-network benefits, you may still want to consider in-network facilities. In-network facilities offer the cheapest option for individuals as the deductibles and out-of-pocket expenses are much lower than receiving services from out-of-network facilities.

Who is Magellan?

Magellan Health is a Fortune 500 health care provider that concentrates on behavioral health, employee assistance program services, pharmacy management, and various other specialty areas. Based out of Scottsdale, Arizona, Magellan employs about 10,700 employees and serves approximated 1 in 10 Americans.

Magellan started out as a psychiatric hospital. For this reason, they are one of the leaders in behavioral health coverages including mental health and substance use disorders. Magellan is dedicated to helping individuals receive care to properly recover from drug use disorders. Individuals who are covered by Magellan can get medical treatment and counseling for mental health conditions and drug abuse. Although protection for these services will differ based on your specific plan.

Will Magellan Insurance Cover My Addiction Treatment?

Different plans will cover certain health conditions to varying degrees. If you attend treatment at Coalition Recovery, yes. Magellan covers treatment for the majority of drug and alcohol use disorders in addition to treatment of co-occurring disorders such as anxiety and depression. Because Coalition Recovery is in-network with Magellan Health, we provide the best chance that your treatment will be covered and at the lowest costs possible

Nevertheless, the treatments and services offered will differ depending on the plan. Some treatment centers that accept Magellan may just offer drug and alcohol detox services. Other treatment centers may only use outpatient programs and group therapy. Here at Coalition Recovery in Florida, we offer the full continuum of care. This includes detox, in-house, intensive outpatient, and even continued care through outpatient counseling: all covered by your Magellan plan. 

Nearly all drug rehab centers provide a variety of treatments to deal with and help individuals recover from any addiction type.

Addictions that may be covered by Magellan include:

  • Alcohol
  • Opioids and opiates (heroin, oxycodone, hydrocodone, codeine, morphine)
  • Cocaine
  • Methamphetamine
  • Hallucinogens.
  • Prescription drugs (i.e., benzodiazepines, ADHD medications, sleep help)

Which Addiction Treatments Are Covered by Magellan Insurance?

Plans provide various levels of coverage for services and types of treatment. The following drug abuse treatment services that may be covered under your plan with Magellan.

Detox

Detoxing helps people safely withdraw from alcohol and drugs and can include medications and medical guidance.

Inpatient

Inpatient programs provide 24-hour healthcare and guidance for those experiencing severe and acute symptoms of withdrawal. They are capable of dealing with significant psychological health problems and/or other conditions that need relatively intensive medical attention.

Residential

Residential programs permit you to live at the treatment center and offer a structured daily regular comprised of individual and group counseling sessions.

Outpatient

Partial hospitalization, intensive outpatient, and outpatient therapy are all types of outpatient programs. They typically enable you to live in the house while visiting the treatment center for a set number of hours weekly. However, Coalition Recovery provides room and board to customers in its intensive outpatient program and partial hospitalization programs who are not from the local area. Partial hospitalization consists of medical care and counseling, whereas others may not include medical care.

Individual and group therapy

Counselings are provided on a private and group basis to help adjust unfavorable behaviors and ideas related to substance abuse. They also help people discover effective ways that can help you stay abstinent from drugs and alcohol.

Dual diagnosis treatment

Almost half of all people with substance use conditions are also diagnosed with a psychological health disorder and vice versa. Dual diagnosis treatment helps individuals simultaneously recuperate from both their substance abuse disorder and mental illness simultaneously.

Halfway house care

Halfway houses or sober living centers are a transitional option for people who have finished a rehabilitation program. They use a structured, drug-free environment for people to continue to get support while they adapt to sobriety.

Methadone treatment

Methadone helps to reduce withdrawal and blocks the results of other opioids to encourage abstinence in people recuperating from opioid dependence.

What it means to be a drug rehab in Tampa

How Does Magellan Insurance Coverage Work for Rehab?

Preauthorization is when your health insurer decides that a healthcare service or treatment is medically required.

The types of substance abuse services and the quantity of protection you get from Magellan will vary depending upon your plan and the state where you live.

When accepted into a program, you may need a preauthorization within the first 48 hours of treatment. However, some plans may need preauthorization prior to admission. Magellan may not cover your treatment if you do not acquire a pre-authorization.

Also known as prior authorization or prior approval, preauthorization occurs when your health insurer requires a healthcare service or treatment. Your insurer and plan may or may not require preauthorization for outpatient services.

Some plans may likewise need you to pay a copayment or coinsurance or satisfy a particular deductible. A copayment is a set amount you spend for a health care service prior to or after you’ve satisfied your deductible. Coinsurance is a percentage of healthcare service costs paid after the deductible is met. A deductible is a cumulative amount you need to pay for certain services before your insurance begins to provide protection.

Many plans with Magellan require you to receive addiction treatment from an in-network carrier, which is a provider that has accepted provide services to a plan’s members for agreed-upon rates. You might wind up paying the full expense or a greater cost for treatment when receiving treatment from an out-of-network service provider. Some plans likewise limit the amount of time you spend in a particular treatment program, though these limits vary based on the plan.

Will My Employer Find Out?

Under federal law, insurance coverage and treatment companies can not reveal to someone outside the rehab center that an individual is getting treatment for a substance use disorder or mental disorder. Your individual client records are strictly private, and your employer will not discover about your drug use disorder and treatment from Magellan or your treatment center.

Magellan’s Approach to Substance Abuse Treatment.

Magellan thinks about medication-assisted treatment a best practice for the treatment of opioid and alcohol use conditions.

This healthcare provider uses a detailed care management approach that supports using efficient, evidence-based treatments for addiction and substance use disorders. Magellan concentrates on providing clinically appropriate interventions and customized substance use training and intends to help all patients accomplish the healthy, independent ways of life after recuperating from drug abuse. They also increase company education guaranteeing they use the right medications as part of a substance abuse recovery strategy.

Magellan considers medication-assisted treatment a best practice for the treatment of alcohol and opioid addictions.

The diagnosis and treatment of co-occurring mental health disorders is a key focus for Magellan. This is due to the approximately 45% of individuals with a drug use disorder also suffer from mental disease.

How Do I Get Started?

To begin with addiction treatment, you will require to validate your insurance advantages. We can discuss your benefits and help you select a treatment center that covers your addiction type and the services you need to recover from your substance use disorder. At Coalition Recovery, we understand that each person has different coverage and individual circumstances. We will work with you to discover the very best possible treatment option.

To confirm your insurance coverage benefits through Magellan, you may call one of our admissions navigators, or use the benefits verification form on Megellan’s website. Whatever you say will remain confidential.

Contact us today at 888-707-2873 for more information about utilizing Magellan insurance to receive treatment with Coalition Recovery.

Leave a Reply

Your email address will not be published. Required fields are marked *

Don't Wait! Take back your life and let Coalition Recovery be your first step

Insurances Accepted

© Copyright 2018 | All Rights Reserved | Coalition Medical Company LLC, DBA Coalition Recovery

Call Now ButtonCLICK TO CALL