Call Magellan toll-free at:
1-877-769-9784 or TTY: 1-877-769-9785 in Bucks County
1-888-207-2911 or TTY: 1-888-207-2910 in Delaware County
1-877-769-9782 or TTY: 1-877-769-9783 in Montgomery County
1-866-238-2311 or TTY: 1-866-238-2313 in Lehigh County
1-866-238-2312 or TTY: 1-866-780-3367 in Northampton County
We are open 24 hours a day, seven days a week to take your calls. Call us at any time when you have questions about your mental health, substance abuse or co-occurring services. If you speak a language other than English, Magellan has staff and providers who speak other languages other than English who can help you. We can also assist you with interpreter services. Many of our providers, as well as their staff, can also assist you with interpreter services.
THE MAGELLAN PROVIDER NETWORK
When you call us, our Customer Service Department will give you addresses and telephone numbers for providers that are located in your area and can best help you with your specific needs. We can help you to choose a provider close to where you live.
You can also refer to a complete listing of our providers including those who speak languages other than English. This listing is available with this handbook or online at www.MagellanHealth.com/member. Magellan will make every effort to honor your request for a specific network provider. However, this may not always be possible. Some of the reasons we may not be able to offer you an appointment with your first choice provider include:
- The provider you chose does not specialize in the area of assistance you need.
- The provider you chose may not be accepting new members or may not have appointments available.
- The provider you chose may not feel they are the most appropriate provider to best help you with your particular needs.
- Providers may leave our network and new providers join our network all the time. You may want to call Magellan to check if a particular provider is currently in our network. We can also tell you if the provider is currently accepting new members.
We will let you know if your provider leaves our network. You can continue to receive covered services from that provider for 60 days from the date we notify you. There may be times when you feel you need to see a provider who is not in our network. If we do not have a provider within our network who is qualified to handle your particular needs, it may be possible for Magellan to arrange an out-of-network provider for you. All out-of-network providers must have prior authorization by Magellan before you can see them in order for your visit to be covered. Please call our Customer Service Department if you feel you need to see an out-of-network provider.
You have the right to request a second opinion from a network provider at no cost to you. If a qualified health care professional is not available within the network, Magellan will help you arrange for a second opinion with an out-of-network provider at no cost to you. All out-of-network referrals must have prior authorization from Magellan.
Our provider offices are able to help you even if you have a physical disability, such as a problem walking, or trouble seeing or hearing. Please call us if you need to make sure a provider's office is wheelchair accessible or for any other special needs you might have.
IF YOU HAVE OTHER INSURANCE
Magellan/HealthChoices is the last payer of your bill when you have other insurance. That means, if you have Medicare or commercial insurance (such as Blue Cross/Blue Shield), you must use that coverage first. That means you must go to a provider who accepts your other insurance.
If your other insurance is Medicare, you must use Medicare first, unless Medicare does not cover the service you need.
If you get services from a provider who accepts both your Medicare coverage and Magellan/HealthChoices, show both of your cards so the provider may submit the claim to Medicare and, if necessary, to Magellan/HealthChoices.
If your other insurance is a commercial health plan, you must use that plan first, unless your plan does not cover the service you need.
If you get services from a provider who accepts both your commercial plan and Magellan/HealthChoices, show both of your cards so the provider may submit the claim to the commercial plan and, if necessary, to Magellan/HealthChoices.