Understandably, concerns about the cost of therapy can sometimes stand in the way of seeking the support you deserve. Fortunately, if you have Magellan Healthcare, your mental health treatment may be covered.
Magellan has a robust network and a reputation for providing valuable mental health coverage. Whether you’re just starting therapy or looking for continued support, it’s worth learning more about your coverage to see if therapy may be covered.
Key takeaways
- Magellan therapy coverage varies by plan, including services covered, copays, deductibles, and session limits
- In-network providers offer lower costs, while out-of-network care may involve higher upfront payments and reimbursement
- Verifying benefits helps clarify coverage details, referrals, and any preauthorization requirements
- Magellan typically covers services like individual, couples, and psychiatric care depending on the plan
Magellan therapy coverage
Magellan offers outpatient therapy coverage for members. However, it’s important to check the specifics of your plan to verify benefit details.
Most Magellan plans offer outpatient therapy coverage for substance use disorders and mental health disorders if treatment is medically necessary. Treatment may be covered for conditions like anxiety, depression, and autism.
According to Magellan, mental health treatment is considered medically necessary when it meets the following criteria:
- It’s in line with the diagnosis or treatment of a mental health condition and adheres to the established standards of sound medical practice.
- It’s essential for reasons other than mere convenience.
- It represents the most suitable and appropriate form or level of service for the given situation.
To learn more about therapy coverage with your Magellan Healthcare plan, you’ll want to locate your Summary and Benefits document. This document outlines the components of your plan, including the types of mental health services that are covered. You can typically access your Summary and Benefits document conveniently via your Magellan online portal.
Did you know?
People are far more likely to seek mental health care outside their insurance network than for any other type of medical care. According to a NAMI report on insurance coverage, a behavioral health office visit is over five times more likely to be out-of-network than a primary care appointment — making it especially important to confirm your specific plan’s in-network coverage before booking a session.
Mental health services not covered by Magellan
The range of mental health services covered by Magellan may vary depending on your plan. However, treatment may not be covered if it’s not considered medically necessary. Your plan may also require preauthorization approval prior to you beginning treatment.
In general, behavioral health insurance coverage may not cover therapy for the following:
- Life coaching
- Career coaching
- Experimental treatments
- Marriage or couples counseling
For a more detailed rundown of exclusions, please be sure to check the Magellan website or contact the phone number provided on the back of your Member ID card.
How to check your Magellan coverage
Reviewing your mental health coverage is a simple and hassle-free process. You can assess your coverage by calling the number printed on your membership card.
Alternatively, for a convenient online option, you can follow these steps:
- Go to the Magellan Healthcare website.
- Click on the link that says “Member” in the top right corner of the page.
- If you have Magellan Behavioral Health benefits through your health plan, select the link that says “Go to Magellan Assist” to login to your plan.
- If you have Magellan Behavioral Health benefits through your employee, select the link that says “Go to Member Portal” to login to your plan.
Once you’re logged into the Members section, you’ll be able to view additional details about covered services, as well as view a copy of your member handbook.
How to find a therapist who accepts Magellan
Starting therapy can be an empowering, but overwhelming, process. Fortunately, there are a number of ways you can search for a provider.
Magellan has an extensive behavioral health network featuring more than 118,000 qualified providers and mental health experts who are available for in-person and virtual sessions through dedicated apps.
Follow these steps to begin your search:
- You can learn about covered therapists by calling the customer service number on the back of your insurance membership ID card or search for a provider on the Magellan website using this provider search tool.
- You can also find a therapist who accepts Magellan coverage using the Grow Therapy website. Simply input your insurance provider, location, and any other specifications to view therapists who meet your criteria.
How much does therapy cost with Magellan?
The out-of-pocket expense associated with therapy varies according to your Magellan Health plan. However, many plans will require you to pay 20-40% per session when seeing an in-network therapist. This means that 20-40% of the total therapy cost would be out-of-pocket, while Magellan Health takes care of the remainder.
To confirm your coverage, get in touch with the member services phone number found on the back of your membership card, or consult your member handbook for supplementary details. It’s crucial to review your plan deductibles, co-pays, and plan limits to confirm what you’ll pay out-of-pocket for therapy.
With Grow Therapy, people with Magellan pay an average of $0-45 per session. You can also a cost estimate before booking a session so there are no surprises.
Final thoughts
Mental health care is most effective when you can access it consistently — and understanding your Magellan coverage upfront removes one of the biggest barriers to getting started. Whether you’re navigating a new diagnosis, managing ongoing mental health needs, or simply looking for someone to talk to, knowing what your plan covers means fewer surprises and more focus on your care.
If you have questions about your specific benefits, the best first step is always to call the member services number on the back of your insurance card or log in to your Magellan member portal. And when you’re ready to find a provider, Grow Therapy makes it easy to search by insurance, specialty, and availability — so you can move from coverage questions to booked appointment in one place.
