Does Magellan Health Cover PHP Treatment for Addiction and Mental Health?
Does Magellan Health Cover PHP Rehab?
Yes, Magellan Health covers PHP treatment for addiction and mental health if a licensed professional considers it medically necessary. Your exact benefits depend on your insurance plan, network status, and other factors.ChoicePoint offers a thorough drug and alcohol evaluation to provide compassionate PHP treatment for eligible Magellan members.
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✓Structured Intensive care
with flexibility -
✓Same-day Magellan
insurance verification -
✓Managing all insurance
verifications on your behalf
Duration and Benefits of PHP Treatment for Addiction and Mental Health?
PHP helps individuals struggling with moderate to severe addiction without 24/7 medical supervision. During the program, patients receive intensive care with the added flexibility to return home after treatment.Ā
The PHP treatment lasts several weeks and follows a structured routine requiring:
- 4-5 days a week
- Up to 6 hours a dayĀ
PHP rehab combines the benefits of both inpatient and outpatient addiction programs without requiring individuals to put their responsibilities on hold. Choosing an insurance-covered PHP treatment offers several benefits, such as:
- Medically administered detoxĀ
- MAT to manage withdrawals
- Addiction therapies
- Professional relapse counselling
- Aftercare planningĀ
- Dual diagnosis care for addiction and mental health
PHP programs may also be offered during the evening to support recovery after work, which benefits working professionals the most.
What Substances Does Partial Hospitalization Rehab Magellan Cover?
Magellan Health covers PHP rehab for the following substance addictions:
Does Magellan Health Cover PHP Rehab for Addiction and Mental Health?
Magellan may cover co-occurring mental health disorders if deemed medically necessary, including:
- ADHD
- Obsessive Compulsive Disorder
- Anxiety Disorder
- Eating Disorder
- Depression, including postpartum depression and alcohol abuse, post-drinking depression
- Behavioral Disorder
- Post-Traumatic Stress Disorder (PTSD)
Substance Use Disorder (SUD) has a devastating effect on mental health. Magellan Health covers dual diagnosis and treats addiction along with underlying mental health complications for the best chance at long-term recovery.
What Affects Magellan Health PHP Coverage?
Magellan Health PHP coverage drastically lowers your personal expenses when seeking treatment for addiction and mental health. However, the coverage extent depends on several factors listed below:
| Factors | How it Affects Coverage |
|---|---|
| Medical Necessity | The PHP treatment must be considered a medical necessity by a licensed medical professional to qualify for insurance coverage. |
| Prior Authorization | Prior authorization may be required for PHP, depending on network status and your specific insurance plan. |
| Specific Insurance Plan | Your specific plan determines your benefits and any copays, deductibles, or out-of-pocket expenses you may be responsible for. |
| Network Status | Out-of-pocket expenses vary depending on whether the treatment provider is in-network or out-of-network. |
Do I have to Pay Despite Magellan Health’s PHP coverage?
While insurance coverage typically covers a significant portion of the treatment cost, you may still be liable for certain out-of-pocket costs based on your individual medical plan.
Listed below are some costs you may be liable for, even with Magellan Health PHP coverage.
| Out-of-Pocket Expenses | Description |
|---|---|
| Deductible | These are mandatory costs you must pay before the insurance provider begins covering treatment expenses. |
| Copayment | Your share of out-of-pocket expenses for rehab treatment, while the remaining cost is covered by the insurance provider. |
| Coinsurance | The percentage of the total treatment cost you are responsible for after the deductible has been met. |
| Out-of-Pocket Maximum | The maximum amount you are required to pay out-of-pocket before the insurance provider covers the full remaining cost. |
| Network Status | In-network facilities generally have lower costs, while out-of-network facilities tend to be more expensive. |
PHP Addiction Treatment Magellan Covers at ChoicePoint
Effective addiction treatment requires personalized care based on dependence and recovery needs. Keeping this in mind, ChoicePoint offers free addiction treatment evaluation to gauge the best-suited addiction rehab for you:
We offer the following PHP services:
| Services | Drug/Substance Addiction | Alcohol Addiction |
|---|---|---|
| Psychiatric Evaluation | ā | ā |
| Medically Supervised Detox | ā | ā |
Medication-Assisted Treatment
|
ā | ā |
| Dual Diagnosis Care | ā | ā |
| Individual Therapy | ā | ā |
| Group Therapy | ā | ā |
| CBT Therapy | ā | ā |
| DBT Therapy | ā | ā |
| EMDR Therapy | ā | ā |
| Relapse Prevention Support | ā | ā |
| Aftercare Support | ā | ā |
| Inclusive Programs | ā | ā |
ChoicePoint Accepts Magellan Health For PHPĀ
ChoicePoint accepts Magellan Health PHP coverage with quick insurance verification to help you get started immediately. To verify your Magellan Health benefits for addiction and mental health PHP rehab, feel free to contact us at 844.445.2565 or verify benefits online.
Here is how to verify your Magellan Health insurance in three simple steps:
Step 1: Verify Insurance Online
Visit the website and navigate to Admissions > āverify your insuranceā through ChoicePoint or call us at 844-44-2565.
Step 2: Fill Out Our Form
Fill out your insurance details and click submit.
Step 3: Receive Benefits Details
Our admissions team will get back to you with your insurance details on the same day.
Check Your Insurance Coverage With ChoicePoint
Whether youāre in Fair Lawn, NJ, or anywhere else in the United States, call 844.445.2565 Our admissions team verifies your exact in minutes and handles prior authorization so you can start treatment stress-free.
FAQs
Here are some frequently asked questions regarding Magellan Health PHP rehab:
What requirements must be met for Magellan Health to approve PHP treatment?
Magellan typically requires a clinical assessment and proof of medical necessity before approving Partial Hospitalization Program treatment. Providers must submit necessary medical information so Magellan can determine whether PHP is the appropriate level of care.
Does Magellan Health require prior authorization for PHP treatment?
In most cases, prior authorization may be required for higher levels of behavioral health care, including Partial Hospitalization Programs. Without authorization, coverage may be reduced or denied.
Do I need a referral from a doctor to enroll in an IOP with United Healthcare?
Referral requirements depend largely on your specific insurance plan. Some plans may require referral, while others allow direct enrollment. In either case, IOP treatment needs to be considered a medical necessity.
Does Magellan Health cover both in-network and out-of-network PHP providers?
Magellan plans may allow both in-network and out-of-network providers, but coverage is usually better with in-network facilities. Out-of-network treatment may require special approvals and may result in higher out-of-pocket costs.
How can I verify my Magellan Health benefits for PHP treatment?
You can verify your benefits by:
- Calling the member services number on your insurance card.
- Logging into the Magellan member portal
- Asking the treatment provider to conduct a benefits verification on your behalf
Other Major Insurance Plans We Accept
