By We Level Up | Editor Yamilla Francese | Clinically Reviewed By Lauren Barry, LMFT, MCAP, QS, Director of Quality Assurance | Editorial Policy | Research Policy | Last Updated: March 13, 2023

Magellan Mental Health Providers & Magellan Mental Health Providers

Magellan Mental Health and Drug Rehab Coverage: The Affordable Care Act (ACA) mandates that all insurance companies provide coverage for mental health rehab services. Additionally, the ACA requires that behavioral health, inpatient mental health, and treatment for substance use disorders (SUD) be covered by all health insurance policies (such as counseling and psychotherapy).

Magellan Mental Health and Drug Rehab Coverage Free Quick Check

Magellan Insurance Mental Health & Magellan Drug Rehab Coverage

About Drug Abuse

Drug addiction is a chronic illness characterized by uncontrollable drug seeking and use, despite unfavorable side effects and potentially permanent brain changes. These brain changes may have an impact on drug users’ normal unhealthy habits. Moreover, drug addiction is a relapsing disorder. Relapse is the act of resuming drug use after trying to quit.

The first step toward addiction is the voluntary act of consuming drugs. But with time, a person loses the ability to decide against doing something. The drug encourages compulsive drug use and desire. The main cause of this is the effects of long-term drug use on brain health. Addiction has an effect on the parts of the brain that control motivation, learning, and behavior. Hence, addiction is a disease that affects both the brain and behavior.

Drug Abuse Disorders

Drug abuse, sometimes referred to as substance abuse, is the use of a drug in dangerous amounts or methods. It is a particular disorder connected to drugs. In the fields of medicine, criminal justice, and public health, drug misuse is described in distinctly diverse ways. Drug use can sometimes result in illegal or antisocial behavior, as well as long-lasting personality changes in individuals.

In addition to potential physical, social, and psychological harm, the use of particular substances may have legal repercussions, albeit these might vary widely depending on the local jurisdiction. When you visit a center for substance abuse treatment, there are thankfully lots of treatment options accessible.

Misuse of substances is defined as a pattern of consuming harmful substances to improve mood. “Substances” can also refer to a variety of chemicals that are not technically drugs, in addition to alcohol and other narcotics (whether they are legal or not). Abuse can be defined as the use of a substance beyond what is intended or recommended, as well as exceeding allowed dose limits.

Drug usage issues affect people of all ages and from all walks of life. Although these illnesses are common, reoccurring, and frequently severe, they are also treatable, and many people recover from them. Thought, emotion, and behavioral changes are brought on by mental diseases. These conditions can affect our decision-making and interpersonal interactions.

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Programs for treating alcohol addiction are covered by Magellan’s medical insurance. Members of Magellan’s health plan also have access to coverage for drug rehabilitation. The treatment benefits for dual diagnoses of addiction and/or co-occurring mental health disorders are also covered by Magellan’s mental health plan.

We Level Up makes every effort to provide you with the most up-to-date information on each carrier’s coverage for substance abuse, but mistakes do occasionally occur. Please get in touch with your insurance carrier directly to confirm coverage levels. You can also contact our staff to get a free insurance check.

Behavioral Therapies at Drug Abuse Treatment Centers

Behavioral approaches support people’s participation in drug abuse treatment, offer rewards for abstinence, change their attitudes and actions related to drug abuse, and improve their life skills to deal with stressful situations and environmental cues that might cause strong drug cravings and start a new cycle of compulsive abuse. Some behavioral therapies that have been proven to be successful in treating substance abuse are listed below (effectiveness with specific abuse substances is indicated in parentheses).

The goal of 12-step facilitation therapy is to improve the possibility that a substance abuser will join and actively participate in 12-step self-help groups, hence encouraging abstinence. There are mainly three main concepts:

• Acceptance includes the realization that drug addiction is a chronic, progressive disease over which one has no control, that life has become unmanageable because of drugs, that willpower alone is insufficient to overcome the problem, and that abstinence is the only alternative.
• Surrender involves giving oneself over to a higher power, accepting the fellowship and support structure of other recovering addicted individuals, and following the recovery activities laid out by the 12-step program.
• Active involvement in 12-step meetings and related activities. While the efficacy of 12-step programs (and 12-step facilitation) in treating alcohol dependence has been established, the research on its usefulness for other forms of substance abuse is more preliminary. Still, the treatment appears promising for helping drug abusers sustain recovery.

The goal of Family Behavior Therapy (FBT), which has shown promising effects in both adults and teenagers, is to address co-occurring issues like behavior disorders, child maltreatment, depression, family conflict, and unemployment. Behavioral contracting and contingency management are combined in FBT. Therapists work to include families in putting the behavioral techniques they learn in sessions to use and learning new skills to make their homes better.

Patients are urged to create behavioral goals anchored to a contingency management system that aims to prevent substance use and HIV transmission. Parents who abuse substances are encouraged to make goals for good parenting practices. Each session includes a review of the behavioral plans, and when objectives are met, rewards are given by loved ones. Patients choose particular interventions from a menu of evidence-based therapy options as part of the treatment planning process. FBT outperformed supportive counseling in a series of comparisons involving teenagers with and without conduct disorders.

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Magellan insurance coverage offers open-access plans, copay-only plans, and high-deductible plans.

• Open-access plans don’t need a referral or a primary care physician, and they let you pick the doctors you want to see.
• Primary care physician visits and generic medications will be covered before you reach your deductible under copay-only plans, which ensures that your payments after paying your deductible will only be copays.
• Preventative care services, sometimes coverage through a primary care physician before the deductible is met (with a fee), and the choice of a health savings account are all provided by high-deductible plans. Logging into the member website will allow you to see the specifics of your plan.

Open-access, copay-only, and high-deductible plans are all offered by Magellan insurance protection. Insurance companies provide a wide range of regional plans supported by the nationwide provider network in order to better support patients in their local communities. Mental health problems typically coexist with drug or alcohol addiction. As a result, if you seek therapy for substance abuse or addiction, it’s imperative to address mental health issues.

Via its Ongoing Care initiatives, Magellan is committed to monitoring patients. Once a week, participants get together to support “alumni” of various treatment programs. Sometimes social events are scheduled to celebrate a victory or a recent recovery. These kinds of programs have a significant impact because they give people ongoing encouragement to be involved in their community.

The customer service team at Magellan insurance provides resources for recovery whenever, day or night. It aids in identifying nearby therapists and counseling services.

Rehabs That Take Magellan: Magellan Mental Health and Drug Rehab Coverage

To learn what your particular plan covers, including coinsurance, copays, and deductibles, you must speak with your insurance provider. Magellan insurance may provide coverage for the following treatment options for substance abuse:

• Detoxification
• Inpatient rehabilitation
• Residential rehabilitation
• Partial hospital treatment
• Intensive outpatient treatment
• Continuing care programs

When choosing the finest rehab treatment center for you, check your policy benefits to discover which costs will be covered by your insurance company and which ones you will have to pay out yourself. Call the number on the back of your insurance card or log into your account on the Magellan website to learn more about the specifics of your coverage plan.

Knowing precisely what your Magellan insurance plan covers may help you feel more at peace when you or a loved one is seeking treatment for substance abuse. You can concentrate on the process of becoming and getting clean without having to worry about unanticipated costs or financial troubles.

• If you’re reluctant to seek addiction rehabilitation therapy out of worry of what others might think, you’ll be glad you have Magellan insurance. Magellan provides members with round-the-clock service and can help you quickly discover a doctor or rehabilitation center. All information you share with your agent will remain secret, and the company will take care of your needs discretely. Your Magellan insurance coverage determines the length of your stay, and the new corporate plan also specifies a combination of private counseling. You will therefore feel secure no matter how long you remain.

• You will likely need to seek treatment at a rehab center that is a part of Magellan’s network in order to receive your full benefits. You can still be responsible for some of the treatment fees even if you choose an in-network institution for addiction treatment. If you choose an out-of-network facility, you can be liable for the full cost of your care. Nonetheless, you are allowed to discuss various forms of financing, such as a payment schedule or any scholarships the establishment might provide.

• Drug and alcohol rehab costs differ from person to person. It largely depends on the treatment center, the program you enroll in, and the specific services you receive. When selecting a rehab center, review the benefits of your Magellan insurance coverage to determine which costs are covered by your insurance and which you will be responsible for paying out of yourself. Call the number on your insurance card or sign in to your account on the Magellan website to find out how much you might have to pay in copays and any deductible that must be satisfied before coverage begins for the treatments you require.

Do Treatment Centers Need to be In-Network? Magellan Mental Health and Drug Rehab Coverage

Despite the fact that not all Magellan insurance plans need in-network providers, out-of-network services could be more expensive. It’s important to keep in mind that programs that aren’t a part of Magellan’s network haven’t been checked to see if they adhere to current standards of care.

Every one of Magellan’s in-network programs is inspected for high standards of care and adherence to modern norms. Ask your insurance provider if pre-certification for your substance abuse treatment is required before you begin the program. Pre-certification involves a review process to see whether the requested service or program satisfies Magellan’s clinical requirements for coverage.

Magellan Mental Health and Drug Rehab Service and Costs, Magellan Mental Health and Drug Rehab

Depending on your location and the scope of your Magellan policy, the cost of inpatient rehabilitation programs may vary. For in-network inpatient services, some Magellan plans offer 0% coinsurance; insurance coverage starts after your whole deductible has been satisfied. Other plans may charge a fee for each admission for other services.

Principles of Top Drug Abuse Treatment Center

Due to the continual growth and variety of treatment approaches and individual programs, many programs today do not neatly fall into recognized categories for drug addiction therapy. Detoxification and withdrawal under medical supervision, which is generally thought of as the first stage of therapy, is where the majority of programs begin. Detoxification is the process by which the body rids itself of toxic substances. It is used to control the abrupt and sometimes dangerous physiological effects of stopping drug use.

Detoxification alone, as previously said, does not address the psychological, social, and behavioral concerns connected to addiction, and as a result, it typically fails to provide the long-term behavioral changes necessary for recovery. A formal examination and referral to drug addiction therapy should come after detoxification. Because withdrawal side effects are generally unpleasant and potentially fatal, detoxification is typically managed using medications prescribed by a doctor in an inpatient or outpatient setting; this is why it is known as “medically controlled withdrawal.” Medication can help with the withdrawal from opioids, benzodiazepines, alcohol, nicotine, barbiturates, and other sedatives.

Types of Drug Treatment Programs

Detoxification and withdrawal under medical supervision, which is generally thought of as the first stage of therapy, is where the majority of programs begin. Detoxification is the process by which the body rids itself of toxic substances. It is used to control the abrupt and sometimes dangerous physiological effects of stopping drug use. Nevertheless, because detoxification alone does not address the psychological, social, or behavioral problems associated with addiction, it rarely has the long-lasting behavioral changes needed for recovery. A formal examination and referral to drug addiction therapy should come after detoxification.

Individualized Drug Counseling

Together with reducing or stopping illicit drug or alcohol use, personalized drug therapy addresses the patient’s rehabilitation program’s content and structure as well as associated areas of impaired functioning, such as employment status, illegal activity, and family/social relationships. By concentrating on short-term behavioral goals, individualized counseling assists the patient in developing coping strategies and resources to prevent drug use and sustain abstinence. The addiction expert encourages 12-step participation (at least twice a week) and makes suggestions for additional medical, psychiatric, employment, and other services that might be necessary.

Counseling Group

Group therapy is employed in a variety of therapeutic settings to promote drug-free living and to gain social reinforcement via peer discussion. According to research, group treatment that is either given with one-on-one drug counseling or that is set up in accordance with contingency management or cognitive-behavioral therapy principles has positive outcomes. Researchers are testing the prospect of standardizing and enhancing group therapy.

Long-Term Residential Treatment

Long-term residential therapy, which is frequently provided outside of hospitals, gives care around-the-clock. The most well-known kind of residential therapy is the therapeutic community (TC), which has stay durations of 6 to 12 months planned. The goal of TC is the “resocialization” of the patient by actively involving the entire program community, including other residents, staff, and the social environment.

The goal of treatment is to assist patients in developing a feeling of social duty and personal accountability. Addiction is viewed in light of a person’s psychological and social flaws. Treatment is extremely structured and can occasionally be aggressive, with exercises designed to help inmates examine negative attitudes, self-concepts, and destructive behavior patterns and adopt new, more harmonious, and productive ways to relate to others. Several TCs offer comprehensive services, which could include on-site job training and other support services.

Short-Term Residential Treatment

Short-term residential programs provide intensive but relatively brief treatment based on a modified 12-step model. Several of these programs, which were initially designed to treat alcohol problems, began to address other types of substance use disorders in the middle of the 1980s as a result of the cocaine pandemic. The initial residential treatment technique consisted of a 3- to 6-week hospital-based inpatient treatment session followed by prolonged outpatient counseling and participation in a self-help group, such as AA. During their stints in residential treatment, people must continue taking part in aftercare and outpatient programs. These services help to reduce the risk of recurrence once a patient leaves a residential facility.

Also, Level Up may confirm your insurance coverage on your behalf. You may quickly determine whether the treatment center you are thinking about is covered by your plan by going to the insurance verification website, entering your information, and viewing the results. To check your benefits and to assist you to understand what is covered, please contact one of our admissions navigators.

Only inpatient programs can be assisted by the We Level Up treatment facility. We can assist you in determining the best course of treatment after first assisting in the assessment of your problem. To find out more, dial. There is never any commitment when you call, and it is private and discreet.