MagnaCare/Brighton Health Plan Solutions Behavioral Health Treatment Coverage and Benefits

Does MagnaCare Cover Behavioral Health Treatment?

MagnaCare is a third-party administrator that manages provider networks and claims on behalf of employer and union health plans. MagnaCare provides the network and administers claims, but your employer's plan decides the benefits. As most of these are self-funded plans, out-of-network coverage varies significantly from one employer to the next, so verifying your benefits in advance matters.

MagnaCare is mainly based in the New York tri-state area, though plans administered by MagnaCare may include limited out-of-network coverage in California. Your coverage is determined by your specific plan.

Your coverage may depend on factors such as:

• Your specific MagnaCare policy
• Whether your plan includes out-of-network benefits
• Whether the treatment is medically necessary
• The recommended level of care
• Whether prior authorization is required
• Your deductible, copayment, coinsurance, and out-of-pocket maximum

Our admissions team can verify your benefits and explain whether your plan may provide coverage for treatment at NuView.

What May Be Covered Under MagnaCare?

Depending on your specific plan and needs, eligible members may have coverage for substance use and mental health disorder treatment.

Treatment that may be covered under an eligible plan can include:

• Clinical assessments and psychiatric evaluations
• Partial hospitalization program (PHP)
• Intensive outpatient program (IOP)
• Virtual behavioral health treatment services
• Outpatient therapy
• Substance use disorder treatment
• Mental health disorder treatment
• Dual diagnosis care services
• Medication management.

The services available to you, your level of coverage, and your potential out-of-pocket costs depend on your specific policy.