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When you first realize that you or a loved one might need rehab, one of your first thoughts is probably, “How much does rehab cost?” Some types of rehab can be pricey, but having insurance can help cut costs. If you have Magellan insurance, here are some things to know when considering the price of rehab.
Magellan Is Legally Required to Provide Addiction Care
First of all, the good news is that you can use your Magellan insurance for rehab. If you are struggling with substance abuse, the company will help cover the costs of appropriate care. The Affordable Care Act mandated that insurance companies provide treatment for substance use disorders. They are legally required to provide the same care for addiction that they would for any other medical condition. Magellan does still have the right to approve and deny coverage based on medical necessity. Almost anyone with a substance use disorder can get approval for an outpatient rehab center. However, to get coverage for inpatient rehab, you will need to show that your substance abuse disorder is fairly severe.
How Your Type of Plan Affects Rehab Costs
The exact answer to how much does rehab cost will depend on which plan you have with Magellan. Some Magellan plans have a copay. This just requires you to pay a certain flat rate, like $20 to $50, every time you have a rehab visit. Other plans have coinsurance, which means you will need to pay a certain percentage of the cost. Finally, you need to consider your deductible. Once your out of pocket costs reach this deductible, Magellan will cover 100 percent of the costs for your care.
Your plan also affects what types of rehab Magellan will cover. Some plans, such as HMO plans, require you to first visit your primary care physician. Once your physician refers you for treatment, Magellan will then cover costs at the clinic the physician recommended. Some plans like PPO plans may cover more of the costs in-network, while out of network rehab centers may cost more. Often, rehab care requires pre-authorization, which means Magellan will only pay if you get approval before you start rehab.
All of this can sound a little complicated, but it is actually easier than you think. Any good rehab treatment center will help you navigate the complexities of insurance. You can contact the center and give them your insurance information. Then, they will reach out to Magellan to verify your insurance and get any necessary authorization for the treatment program that would best address your needs. Having your healthcare provider handle all the insurance details for you lets you focus on care instead of dealing with paperwork.
Will Magellan Cover Medications During Rehab?
Whether or not Magellan provides medication coverage depends on your situation. Typically, they will cover any medication as long as it is prescribed during the course of your treatment. For example, if you are in a partial hospitalization program and need anti-nausea medications during withdrawal, Magellan would cover that. However, they may not cover medication costs once your treatment is over. To get ongoing coverage, you would need to show that it is necessary to assist with sobriety.
Magellan Insurance is currently part of a national initiative to expand the use of medication-assisted treatment. This is a new rehab technique that involves providing people with medications like buprenorphine and naltrexone. These low dose, slow-acting opioid substitutes can be used without impairment. They help to reduce withdrawal symptoms and drug-seeking behavior while a patient is getting appropriate substance use disorder treatment. Magellan will cover medication-assisted treatment costs just like the costs of any other prescribed medication. Depending on your plan, you may pay a copay, or the costs for this medication can be covered entirely.
What Sorts of Therapies Are Covered by Magellan?
Magellan will cover just about any therapy that has been shown to help with addiction or other co-occuring mental health disorders as long as the therapy is offered by a provider in the Magellan network. This is mostly clinical psychotherapy, but there may be some limited coverage for more holistic therapies as well. Magellan recognizes the importance of therapy with your peers, so you may be able to get coverage for both group and individual therapy. Some of the types of evidence-based therapy covered by Magellan include:
How Magellan insurance for rehab handles therapy costs depends on your rehab program. Some rehabs provide an all-inclusive treatment program. In these programs, Magellan pays a flat rate for your care the entire time you are there. Other rehabs are on a per-visit payment program. You would pay a copay each time you have a therapy appointment, and then Magellan would help cover the rest of the costs.
How Does Magellan Decide Which Rehabs Are In-Network?
Most of Magellan’s plans only cover treatment at in-network facilities. These are a group of providers that have specifically agreed to work with Magellan. To become part of a network, a healthcare clinic needs to meet very stringent requirements and offer certain discounts for Magellan members. Insurance companies will only add a rehab center to their network if it is a fully accredited facility. These rehab facilities need to use evidence-based treatment and provide care according to medical guidelines. This means you can trust that any in-network facility will meet rigorous standards.
Mission Harbor works with Magellan Insurance to make sure you get the best care possible without breaking the bank. Our dual diagnosis treatment center provides a wide range of addiction and mental health treatment. We offer a variety of outpatient programs tailored to fit your unique needs. Call now to learn more.
The facilities at Mission Harbor are staffed with trained experts to best assist patients with their mental health issues. We are capable of dealing with any and all cases with a licensed staff, equipment, and approved techniques. Our mission is to help those who want to help themselves, and we support your decision in seeking help.
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