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Does Magellan Healthcare Cover Alcohol Rehab?

Magellan Health specializes in substance abuse and mental health issues. In addition, the Affordable Care Act (ACA) requires all health insurance companies to cover substance abuse treatment. This includes treatment for alcohol use disorder (AUD).

Most Magellan plans cover at least part of the treatment cost. Treatment programs that are in-network with your particular plan might be completely covered. For those that are out-of-network, Magellan may pay only half.

To avoid receiving an unexpected bill, it’s crucial to verify your coverage before starting treatment. 

Cost of Alcohol Rehab

The price of a particular alcohol rehab program depends on two basic factors:

1. Type of Facility

An alcohol rehab facility can be either for-profit or non-profit.

For-profit facilities can cost up to twice as much as non-profit ones. One study of residential treatment programs averaged the difference in monthly fees between for-profit and non-profit treatment centers at $17,434 to $5,712, respectively.1 

For-profit rehab centers often have more amenities, like pools or saunas. They might also be located near a beach or in the mountains. For these reasons, they tend to market themselves as “luxury” treatment centers for the wealthy.

Non-profit rehab facilities usually only offer the basics: a room with a bed, a bathroom, a place to store your possessions, and sometimes a television. Insurance providers are more likely to cover the costs at these facilities.

Aside from choosing an in-network non-profit treatment facility, one other way to minimize the cost of an alcohol rehab center is to choose a program with a large enrollment. Studies show treatment centers with large enrollment numbers charge less per person.4

Note: Treatment success is not dependent on whether you attend a ‘luxury’ or less expensive facility. Both treatments have been shown to be effective.

2. Type of Treatment

Treatment type will have a significant impact on cost:

  • Outpatient treatment costs $32 to $385 per week, on average.4
  • Inpatient treatment costs $213 to $2070 per week, on average.4

Inpatient treatment involves around-the-clock care, so it tends to be more expensive. 

The use of medication will also increase the cost of treatment. For example, medication-assisted treatment (MAT) with naltrexone costs up to $14,000 per year.5

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Which Addiction Treatments are Covered by Magellan Insurance?

Magellan Healthcare covers a variety of treatments for alcohol addiction and other substance abuse issues.

These treatments include:

Detoxification

Also known as detoxing, this is the first step in the alcohol rehab process. It’s also one of the most dangerous. 

To detox from alcohol means to stop drinking so your body can return to normal. Depending on how dependent a person is on alcohol, detox can result in withdrawal symptoms. 

When the body becomes dependent on alcohol, brain and body chemistry change. The body depends on alcohol to keep some body systems running. Stopping alcohol suddenly without medical support can result in brain and body malfunction, fluid balance upset, and even seizures and death.

Similar occurrences may occur when a person’s body becomes dependent on other drugs.

Alcohol withdrawal symptoms can be life-threatening, and someone undergoing the process needs medical support.

Inpatient Treatment

Inpatient alcohol treatment centers offer 24/7 medical attention and support for patients who need help overcoming their addiction. 

People with severe alcohol addictions often start here and later move to outpatient treatment. They receive therapy in a hospital-type setting with beds, meals, and available nursing/medical care. 

Outpatient Treatment

Outpatient treatment is less intensive than inpatient treatment. There are, however, intensive outpatient programs. People usually attend treatment sessions for several hours per day, a few days a week. They return home when their sessions are done.

Those attending outpatient treatment typically have less severe cases of alcohol addiction or originally started off in inpatient care. 

These programs are also usually more successful for people with stable home environments. Their abstinence and recovery can be supported at home in a less structured environment. 

Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT) is the use of medication to manage withdrawal symptoms during detox. This is known as a medical detox. It’s also commonly used in combination with counseling to reduce cravings and prevent relapse. 

Magellan Healthcare believes MAT is a best practice and “evidence-based approach” to treating substance abuse.

Common medications used in alcohol rehab include:

All three of these drugs are FDA-approved for MAT to treat alcohol addiction.

Mental Health Treatment

Magellan Healthcare recognizes the link between substance abuse and mental illness.

A mental health problem can be either a product or cause of a substance use disorder (SUD) like alcoholism. This complex relationship is known as a dual diagnosis.

There are several mental health disorders linked to alcohol addiction, including:

When handling a dual diagnosis for alcohol addiction and a mental health disorder, it’s essential to treat both at the same time. This is referred to as integrated treatment

Integrated treatment combines mental health counseling with a mix of both psychiatric and addiction medications. Magellan covers evidence-based mental health counseling for alcohol addiction.

Evidence-based therapies for alcohol use disorder (AUD) include:

How Can You Verify Your Magellan Insurance Benefits?

There are two ways to find out what your Magellan health plan will cover:

  • Log onto the Member Services portal on Magellan Assist
  • Call their eligibility and benefits hotline at 1-800-327-7390
Updated on May 19, 2022
11 sources cited
  1. Beetham, Tamara. “Admission Practices And Cost Of Care For Opioid Use Disorder At Residential Addiction Treatment Programs In The US.” Health Affairs, vol. 40, no. 2, 2021.
  2. BlueCross BlueShield of Texas. “Behavioral Health.” 
  3. Fortune Magazine. “Magellan Health.
  4. French, Michael T. “The Economic Costs of Substance Abuse Treatment: Updated Estimates and Cost Bands for Program Assessment and Reimbursement.” Journal of substance abuse treatment, vol. 35, no. 4, 2008, pp. 462-9.
  5. Kaskutas, Lee Ann. “Costs of day hospital and community residential chemical dependency treatment.” The journal of mental health policy and economics, vol. 11, no. 1, 2008, pp. 27-32. 
  6. Magellan Health. “Magellan Health.
  7. Magellan Healthcare. “Magellan Assist.
  8. Magellan Healthcare. “Magellan’s approach to behavioral health.” 2021.
  9. Magellan Healthcare. “Overcoming substance use disorders.” 2017.
  10. Magellan Healthcare. “Substance Use Disorder.” 2021.
  11. National Institute on Drug Abuse. “Evidence-Based Approaches to Drug Addiction Treatment.” 3 Jun. 2020.

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