Frequently Asked Questions

Who is eligible to use behavioral health benefits? 
Behavioral health benefits are available to you as the subscriber and your covered dependents on your health plan.

Is there a cost for these services? 
Typically, co-insurance or copayments and/or annual deductible and out-of-pocket costs.

What should I do when detoxification or rehabilitation services are needed? 
When it comes to drug and alcohol addiction, we understand that it’s difficult to manage a situation where you or a loved one need to admit you have a problem and seek help. 
If you (or a loved one) have an addiction and want to get sober please give us a call at 1-800-442-4123  and follow the prompts.

What services require pre-authorization? 

  • Pre-Authorization is not needed for routine outpatient therapy or medication evaluation and management.
  • Pre-Authorization is required for non-routine outpatient care (psychological testing, Electroconvulsive therapy, Transcranial Magnetic Stimulation, ABA services for Autism, etc.) Please contact Magellan Health at 1-800-442-4123 for other services requiring pre-authorization not listed here.
    • This includes both in-network and out-of-network providers and facilities.
  • Pre-Authorization is required for all higher levels of care including Intensive Outpatient, Partial Hospitalization, Residential Treatment and Inpatient Hospital care.
    • This includes both in-network and out-of-network providers and facilities.

What may happen if pre-authorization is not obtained?

  • Your benefits may be reduced, or the Plan may not pay any benefits.
  • You may be responsible for the unpaid balance of the bills.
  • You may be responsible for additional penalties for failure to pre-authorize.

If you have questions about whether treatment requires pre-authorization, please call 1-800-442-4123 and follow the prompts.  We can also help you find an in-network counselor, psychiatrist or facility.

What is therapy? 
A therapist is a licensed mental health professional who helps clients improve their lives, develop better cognitive and emotional skills, reduce symptoms of mental illness and cope with various challenges. Therapy is a time-tested tool that helps people with a variety of issues including anxiety, depression, grief, relationship problems, self-exploration, stress, substance abuse, trauma and more. 
There are many misconceptions about what it means to talk to a licensed professional and the stigma associated with it is often the reason people don’t seek help in the first place. However, therapy can help people manage issues, develop coping skills and improve their quality of life.

Is there a self-assessment tool to help me identify concerns? 
Take a self-assessment to get recommendations. Once you complete the assessment, you may see access codes, so you can start one of several, self-paced online programs. Select programs can also be downloaded as mobile apps. 
As part of your suite of services, you may access these self-care online programs for common behavioral health conditions, including anxiety, depression, insomnia, chronic pain, and substance misuse.