When it comes to treatment for substance use or mental health disorders, insurance can take on a new importance. Fortunately, Pacific Sands Recovery in Santa Ana, California is an in-network provider with Magellan Health and so accepts Magellan insurance for rehab services. Better still, the admissions team at Pacific Sands can go over potential new clients’ insurance options. In this way, we will find the most appropriate and affordable treatments.
Does Magellan Cover Substance Abuse Treatment?
As part of the Affordable Care Act (ACA), all insurance providers are required to provide full or partial coverage for substance use disorder treatment. That said, the amount of coverage one might have depends on one’s state of residence, whether the facility is in-network or out-of-network, and the level of one’s insurance plan. Also counting for variations in coverage is the type of rehab center, the type of treatment program, and specific related services.
Any limits applied to substance use or mental health treatment services cannot be more restrictive than limits placed on medical services. These include prior authorizations, length of treatment, deductibles, copays, and out-of-pocket expenses.
Perhaps unsurprisingly for an organization specializing in behavioral health, Magellan offers robust coverage of substance abuse treatment. This is offered as part of its LifeResources coverage. Just how much a specific service is covered can vary from state to state. It can also vary by the type of Magellan plan one has.
The Employee Assistance Program (EAP) deems Magellan members’ need for substance abuse treatment necessary. Therefore, the first step one must take to secure coverage for substance abuse treatment is to contact one’s EAP counselor or Human Resources department.
What Kinds of Addiction Treatment Does Magellan Cover?
While Magellan Health provides excellent benefits for substance abuse and mental health treatment. Generally, Magellan covers the following services:
- Detox. Medical detoxification helps clients withdraw from the substances they abuse in an environment that is safe, secure, and comfortable.
- Inpatient rehab. Also known as residential treatment, clients in an inpatient rehab are required to live at the rehab facility or in nearby housing while in treatment.
- Outpatient (OP). People in traditional outpatient treatment receive the services they need while remaining at home to fulfill work and family obligations.
- Partial hospitalization (PHP) treatment. A more intensive outpatient treatment program for people presenting a high risk of relapse, or those with a medical or mental health disorder requiring immediate intervention.
- Intensive outpatient (IOP) programs. IOPS are for those needing intensive care but with the flexibility of allowing them to live at home. Most IOPs offer detox as well as certain medical services.
- Aftercare services. This can include alumni programs, continued counseling and therapy, relapse prevention programs, and sober living stays.
Any service that falls under the addiction treatment umbrella is at least partially covered if that service is deemed medically necessary. This can include individual, group, and family therapy, medical detox, mental health services, and other services. Magellan plans. don’t cover most experimental therapies and most holistic therapies.
One’s insurance coverage varies depending on whether one needs residential inpatient treatment or outpatient treatment. In general, Magellan 100% covers inpatient treatment with a network provider. For out-of-network inpatient facilities, Magellan covers 50% of the total cost.
It’s a good idea to look over one’s summary of benefits to know what services Magellan plans cover. If questions remain, one should reach out to a Magellan representative.
Will I Have to Pay a Deductible for My Treatment?
The short answer to the above question is: it depends. With any Magellan Health plan, there is in-network and out-of-network coverage. For Magellan insurance rehab facilities, the provider is contracted with Magellan to provide treatment services to Magellan members. These members pay less for such services via lower copays and deductibles.
Furthermore, Magellan may provide total coverage of some in-network treatment programs. Out-of-network providers, meanwhile, will cost Magellan members more for treatment services via higher copays, as well as higher coinsurance costs and deductibles.
Before deciding which rehab center might be most appropriate for one’s needs, members should check their benefits. In doing so, one reaches an understanding of which costs are covered by one’s insurance provider and which costs will be out-of-pocket. Knowing exactly how Magellan insurance covers rehab offers peace of mind. Then, the hard work of getting and staying sober can occur with renewed focus.
Learn More About Magellan Insurance for Rehab in Santa Ana, CA
When addiction touches someone’s life, nearly everything—from physical and mental health to finances and family relationships—turns upside down. Pacific Sands Recovery Center in Santa Ana, California knows how to help those struggling with addiction. Better yet, we will work with your insurance company to find the most appropriate and affordable means of treatment.
We understand what a big step it is for someone struggling with addiction to reach out for help. Our compassionate treatment team can answer any questions you might have about the process.
Visit our admissions page to find out how you can utilize your Magellan Insurance for rehab with Pacific Sands Recovery.