Magellan Health Coverage for Addiction & Mental Health Treatment
Federal parity law requires Magellan Health and most other plans to cover substance use and mental health treatment on par with medical care. Verify your specific benefits — free, confidential, in about 15 minutes.
About Magellan Health Behavioral Health Coverage
Magellan Health (now Magellan Healthcare, a subsidiary of Centene) is a specialty behavioral-health benefits manager. Magellan does not typically issue its own insurance plans — instead, it administers behavioral-health benefits as a carve-out for many employer-sponsored plans, state Medicaid programs, and TRICARE in certain regions.
What Magellan Health Typically Covers
Under the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA), Magellan Health must cover substance use and mental health services at parity with medical/surgical benefits. Specific covered levels of care include:
Medical Detox
24/7 medical supervision during withdrawal. Typically 3-10 days, usually fully covered when medically necessary.
Inpatient Hospitalization
Acute psychiatric or medical stabilization in a hospital setting. Pre-authorization required.
Residential Treatment
24-hour clinical care at a non-hospital facility. Coverage varies; often requires step-down from inpatient or PHP.
Partial Hospitalization (PHP)
5-6 hours/day, 5 days/week. Step-down from residential. Generally well-covered.
Intensive Outpatient (IOP)
3 hours/day, 3-5 days/week. Highly covered across plans.
Standard Outpatient
1-2 sessions per week with a therapist or psychiatrist.
Medication-Assisted Treatment
FDA-approved medications for opioid and alcohol use disorder.
Telehealth Therapy
Virtual psychiatry and counseling, typically covered at in-person rates.
Magellan Health Plan Types and Network
If your medical insurance is through one carrier but the back of your card shows Magellan or Magellan Behavioral Health for mental-health services, your mental-health and substance-use benefits are administered separately by Magellan. Magellan network includes thousands of inpatient, residential, and outpatient providers across the US.
Pre-Authorization for Magellan Health
Magellan requires pre-authorization for inpatient psychiatric, residential, PHP, and IOP admissions. Magellan uses ASAM criteria for substance-use level-of-care decisions and its own Medical Necessity Criteria for mental-health admissions. Concurrent reviews continue throughout treatment.
Frequently Asked Questions
My medical card does not say Magellan — how do I know if Magellan manages my behavioral-health benefits?
Look for a separate phone number on the back of your medical insurance card, usually labeled Mental Health or Behavioral Health. If that number routes to Magellan, your behavioral-health benefits are carved out to them.
Does Magellan cover residential addiction treatment?
Yes. When medically necessary under ASAM criteria and pre-authorized, Magellan covers residential treatment. Specific coverage limits depend on the underlying plan that contracts with Magellan.
Does Magellan cover MAT?
Yes for the counseling and behavioral-therapy portion. MAT medications themselves are usually covered under the medical plan pharmacy benefit rather than through Magellan.
Can I get out-of-state treatment with Magellan?
Yes, with prior authorization. Magellan network is nationwide, and out-of-state placements are routine when clinically appropriate.
Find Out What Your Magellan Health Plan Covers
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