My practitioner has mentioned Magellan Healthcare What is Magellan Healthcare and what is the relationship to me?
Magellan Healthcare is a provider network organization. A variety of payers including health plans, PPO’s, HMO’s and others contract with Magellan Healthcare to provide certain specialty practitioner panel(s) for their enrollees. Magellan Healthcare manages networks of chiropractors, acupuncturists, massage therapists, physical therapists, occupational therapists, and speech therapists. Your health plan may access one or more of these specialty networks. Magellan Healthcare manages these provider networks by assessing & approving providers for participation based on their credentials and providing utilization management, quality management and claims processing services.
Which practitioners should I go to for my highest benefit level?
Contact your health plan as identified on your identification card to inquire which practitioners in your area are considered in-network. Practitioner networks vary by plan and the plan accesses Magellan network providers only for certain specialties.
What services and supplies are covered through Magellan Healthcare?
Contact your health plan as identified on your identification card to inquire which services and supplies are covered under your plan. You should do this prior to your visit to your practitioner if you are unsure. Benefits for coverage vary widely amongst plans and Magellan Healthcare does not have or provide information on benefits or your eligibility.
Should I contact Magellan Healthcare if I have a question with my claim payments?
No, your coverage and payment determinations are made by your health plan as identified on your insurance identification card. If you have questions about Explanation of Benefits you received from your health plan, you should contact them directly as identified on your identification card.