Rehabs that Accept Magellan Insurance
Magellan Health is an insurance company and medical benefits provider specializing in behavioral healthcare. Currently, Magellan is headquartered in Scottsdale, Arizona. Magellan’s focus on behavioral health is rather unusual in the insurance industry, making the carrier well qualified to provide many forms of substance abuse and mental health coverage. Treatment and rehabilitation of persons suffering from a substance abuse problem are critical.
Whether you are dealing with a drug or alcohol addiction, detoxification treatment and rehab are crucial. The Affordable Care Act (ACA) mandates that all health plans in the United States, including Magellan plans, cover at least a portion of the costs associated with addiction treatment. As rehabilitation is termed a treatment for substance use disorder (SUD), it falls under the classification of mental and behavioral health services, which are considered essential health benefits under the ACA. Because of this, the vast majority of insurance companies must provide coverage to some degree for this treatment type.
What is a “Magellan Approved Rehab?”
Any facility, center, or healthcare provider that provides rehabilitation services and addiction treatment while accepting Magellan Health Insurance policies can be “Magellan Approved.” Healthcare providers that accept Magellan Health will allow persons to access, depending on the specific nature of their plan, partial or complete coverage of the cost of their treatment.
In-Network vs. Out-of-Network Facilities
Whether the facility you seek treatment with is “in-network” or “out-of-network” significantly affects how much the overall treatment cost is. This can feel convoluted and complex, but it’s pretty simple at its core. It works because some facilities and healthcare providers have established contracts with insurance providers. This makes them a part of that insurance’s “network.” As a result of the agreement, those costs of treatment and care at these facilities are typically lower overall and, consequently, the out-of-pocket costs end are significantly reduced. Providers that are out-of-network usually end up costing quite a bit more. Remember that just because a provider is an out-of-network facility, it doesn’t mean that they won’t accept your insurance. Nevertheless, it is still best to search for and use a healthcare provider that is “in-network” with your particular insurance company if possible.
Tiers of Plans
With Magellan, according to what treatment is necessary for your particular situation, your out-of-pocket obligations would not surpass the following amounts:
- Individual in-network: $4,000
- Individual out-of-network: $8,000
- Family plan, in-network: $8,000
- Family plan, out-of-network: $16,000
Many factors can influence the level of coverage you will experience. These vary from person to person. What state you reside in, the length of your stay, the network status of the healthcare provider, and the specifics of your insurance plan all contribute to the level of coverage. The overall cost of treatment also varies across healthcare providers and is determined by the type of treatment one tries to access.
Magellan Substance Abuse Treatment Options
The specifics of accessing care through insurance are intricate. There are many common questions asked by persons in the course of searching for treatment. “Will my Magellan policy cover medical detox?” “Can I get dual diagnosis treatment with Magellan?” “Is medication-assisted treatment possible with Magellan?” “Can Magellan insurance cover residential treatment?” “Does Magellan cover aftercare services or sober living?” As we said, there are countless questions. However, let us dive into it as straightforwardly as possible regarding addiction treatments. Here are several of the treatments and programs for Substance Use Disorder Treatment that are afforded coverage by Magellan policies:
Medication-Assisted Treatment (MAT)
One of the more common methods for battling addiction is MAT, combining therapy and medication treatments. MAT uses FDA-approved medications that are scientifically proven to help persons overcome opioid and alcohol addictions.
Medical Detox
When someone is in the initial stages of detoxing from substance addiction, the process is painful and requires around-the-clock support and monitoring. This treatment ensures that professional clinicians provide this.
Inpatient Treatment
For persons with severe cases who need intensive care to get to the other side of addiction, inpatient treatment is usually the best option for you. This can include oversight by a physician and 24/7 monitoring for the entire duration of treatment.
Partial Hospitalization Programs (PHPs)
Generally, Partial Hospitalization Programs are seen as step-downs from the more intensive Inpatient programs. The patient usually spends most of the day at the center or facility but returns home at night with this treatment.
Outpatient Treatment
Outpatient care is one of the less intensive programs. Typically, the patient visits the facility or healthcare provider regularly. Typically, the schedule can be as little as once or twice per week.
Intensive Outpatient Programs (IOP)
IOPs are treatment plans that require that patients attend treatment programs with a longer duration than the standard outpatient treatment program.
Aftercare
Aftercare refers to treatment focused on supporting and sustaining the patient’s sobriety after they have gone through the intense treatment and therapy process. This can include support groups, therapy, community programs, and more.
What are the Regions Serviced by Magellan?
Magellan works with over 77,000 healthcare providers across the United States to provide benefits and care to over 33 million persons.
Premiums and Deductibles
The idea of premiums and deductibles is an inherent part of how insurance policies work. How does this pan out in its execution? The premium is the monthly amount that you pay into the policy. Before your insurance policy kicks in to cover the cost of your treatment, you pay your deductible out-of-pocket. A higher premium usually means that you pay a smaller out-of-pocket deductible. Conversely, if you opt to pay a lower premium monthly, the deductible is generally higher. To summarize, for persons willing to pay more out-of-pocket when you need to access care, you can opt for a lower premium with lesser monthly payments into your policy.
Typical Features of Approved Magellan Rehab Programs
Though the specifics of treatments and programs change from facility to facility, some things generally indicate an effective and worthwhile facility with high-quality programs and treatments. Before checking either yourself or a loved one into any program or treatment regimen for substance rehabilitation, you must do your research beforehand. By keeping the following factors in mind, you can be more equipped to make an informed and sound decision about what you or your loved one might need:
PROPER STAFF CREDENTIALS
A legitimate healthcare provider will have their therapy and programs administered and executed by adequately certified and trained staff. Practitioners with advanced education, certifications, and qualifications typically use properly vetted and science-backed techniques and practices. It should be easy for you to determine how the staff is qualified. If it’s not, that can be cause for concern.
PROGRAM ACCREDITATION
An accredited program or treatment process is a good marker of a quality facility and program. Legitimate addiction treatment facilities often undergo the process of accreditation in addition to meeting requirements that may be mandated by the state they operate in. If a facility or program is granted “accredited” status, there has been rigorous and extensive evaluation by a respected third-party entity. The Joint Commission Accreditation for Addiction Treatment (JCAHO) and the Commission on Accreditation of Rehab Facilities (CARF) are two relevant bodies that currently handle accreditation. Endorsement by either entity is a good sign that the provider operates and adheres to high healthcare standards. Treatment programs and facilities may only become accredited by offering a high quality of care. There is a burden of proof on accredited facilities to show that they employ appropriately trained staff, operate according to high safety standards, are culturally sensitive, HIPAA-compliant, and more, so you may be assured that the treatment will be safe and your rights rigorously protected.
FINANCING OPTIONS
There is usually transparency and a willingness to work to help you access treatment despite your financial limitations at reputable and trusted facilities. Suppose you are given assistance and help in figuring out your financial obligations for treatment and what options for support may be available to you. In that case, there’s a perfect chance that the facility in question adheres to a high level of quality in other aspects of its operation. While they may not be able to give every detail about the cost, they should be willing to make visible efforts to help you understand your coverage and any other financing options, including sliding scale payments. Addiction affects individuals of every socioeconomic status and standing; therefore, a facility that recognizes financial restrictions that their patients face and works with them to figure it out is likely to be a sincere advocate for their recovery progress.
TAILORED TREATMENT PLANS
Addiction treatment is not a one-size-fits-all process. Creating bespoke, customized plans that cater to the individual’s specific situation and unique needs is often a necessary component and not something that should be considered optional. A healthcare provider that does not operate this way by default should be avoided as that may signify a lower-quality program. Quality treatment addresses the various components of addiction, including but not limited to any associated psychological, medical, or social issues. A customized treatment program offers a suite of services as is required to save the patient. For example, particular therapeutic approaches are often a requirement for dual-diagnosis patients. Quality facilities usually do an extensive evaluation before admittance and create a comprehensive action plan that considers your personal stressors, supports, and circumstances.
ACCESS TO PROFESSIONAL MEDICAL CARE ONSITE
Substance Abuse impacts both the body and the mind in many ways, which might not be overly apparent before the withdrawal phase. Due to this, the presence of professional medical staff is critical to address any physical and mental health concerns that arise due to the physiological dependence and associated withdrawal syndromes of being deprived of it. The care received during detoxing is essential for managing withdrawal from opioids and alcohol due to severe discomfort, pain, and the potential for medical complications.
LIFE-SKILL TRAINING
The goal of treatment is for the patient to live a fulfilling, satisfying and successful life after the treatment has concluded. To reintegrate into the world, specific life skills must be developed (or redeveloped) that allow the patient to cope with the stressors of life that frequently pop up. A high-quality treatment center will almost always offer some form of life skill coaching so that the patient may be equipped with the requisite knowledge and skillsets to live independently.
LOCATION
In some instances, social and environmental triggers can potentially increase the chances of relapse. Especially in the early recovery phases, it is beneficial and crucial to eliminate as many triggers as possible so the patient may be able to focus on their recovery journey without distractions. Calm, serene, and inspiring surroundings offer an opportunity to connect with nature’s inherent beauty. However. While location CAN be critical, the truth is that there are many rehab programs without a lengthy list of plush amenities or scenic environments that still do provide a high quality of services. The program and facility’s treatment approach should be the main focus.
AFTERCARE PLANNING
Aftercare is a necessary, non-optional component of treating addiction effectively and long-term. Quality rehabilitation facilities focus a substantial amount of their resources and attention on the aftercare plan for each of their patients. It is usually the responsibility of a staff member to develop a plan for the care and support of the recovering patient after acute treatment. This plan can include things such as:
- Individual or group therapy sessions.
- Step-down program from inpatient care to a formal sober living environment externally, usually done gradually.
- Continuous and sustained outpatient treatment.
- 12-step program or other applicable and well-suited recovery support group.
Without a targeted aftercare plan, the risk of relapse can be high. A facility that does not account for this may be offering care of a lower level of quality.
Find Lasting Recovery With Magellan Coverage At Pathfinders
Pathfinders Recovery has been in the business of treating and rehabilitating persons struggling with substance abuse and addiction for over twenty years. Our wealth of experience is wielded by our expert medical team and holistic care professionals who are ready to work with you or your loved one as you navigate the process of detoxing, healing from whatever psychological trauma resulted in the substance abuse, as well as the essential operation of aftercare that gently glides our clients into post-treatment life. A happy and fulfilling life is our goal for every client seeking treatment with us, and our results speak for themselves. If you or someone you love needs treatment for substance abuse issues, we are here to tell you that hope exists! Contact us today for more information or a consultation!
