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Humana Coverage for Detox & Addiction Treatment

Addiction is a disease that affects people from all walks of life. Humana offers plans with numerous treatment options for those battling a substance use disorder. The extent of coverage varies by plan and location.

Humana offers health insurance coverage to people across the country — from families to senior citizens to military veterans. The company offers individual and family insurance, dental and vision options and insurance through employers.

Humana Behavioral Health, a subsidiary of the company that manages behavioral health benefits, provides high-quality behavioral health and substance abuse services. Clients with anxiety, depression, bipolar disorder or drug and alcohol addiction could benefit from these services.

The Humana network includes more than 350,000 medical providers, more than 3,000 hospitals and nearly 50,000 pharmacies. Humana Behavioral Health serves more than 5 million members and offers a variety of health behavior resources.

Types of Treatment Covered by Humana

President Barack Obama’s health care law requires that most individual and small employer health insurance plans cover mental health and substance use disorder services. However, the type of coverage varies by plan and location.

Your plan’s behavioral service package includes several benefits. It provides access to a participating behavioral health network of individual providers, hospitals and mental health and substance abuse programs.

Humana’s health benefits program may also:

Depending on your location, Humana may cover some of the costs of inpatient and outpatient services for those with substance use disorders.

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Inpatient Services

Inpatient treatment facilities generally provide structure and around-the-clock care to people battling moderate or severe addiction. During this time, certified health professionals assist people through the detoxification phase of treatment. They also use counseling to teach individuals ways to live healthy lives free of drugs or alcohol.

The length of stay is contingent upon your insurance coverage and the severity of your addiction. You could remain at an inpatient facility for several months. Check your policy for more details on the length of stay Humana will cover.

Outpatient Services

Outpatient treatment is less intensive than inpatient services for those with substance use disorders. Outpatient services often involve therapy sessions and support group meetings at a rehab facility, but most people can continue to live at home and attend work during treatment. You can receive the help you need while adhering to your daily routines.

Aftercare Services

Humana understands that support and assistance is needed well beyond discharge. The company offers aftercare services to those who need additional support to abstain from drugs or alcohol after treatment. Aftercare generally includes 12-step meetings and individual counseling.

The company provides telephone support to members for 30 days after discharge from inpatient care. Representatives help members schedule their follow-up appointments with providers, connect them with support groups and encourage them to fill their prescriptions.

Some plans offer a smoking cessation program. Personal coaches provide articles and resources to help individuals quit smoking.

Treatment for Co-Occurring Disorders

Many people with a drug or alcohol addiction also have a mental health disorder. All individual and small group plans offer mental health services as required by the Affordable Care Act.

Treatment facilities across the country cater to people with co-occurring disorders, treating addiction and any other existing disorders simultaneously. Untreated mental disorders can result in more serious health conditions.

Preauthorization Requirements

Humana Behavioral Health manages preauthorization requests for behavioral health and substance abuse services for Humana commercial and Medicare members. Preauthorization allows insurers to confirm whether services are medically necessary.

Through Humana, preauthorization is not required for Medicare Advantage Private Fee-for-Service members and for services provided by nonparticipating health care providers for Medicare Advantage PPO members.

Services requiring preauthorization through Humana Behavioral Health include inpatient hospitalization, partial hospitalization, residential treatment, electroconvulsive therapy, applied behavioral analysis and transcranial magnetic stimulation.

Humana Behavioral Health offers an online preauthorization tool for participating providers. This tool provides 24-hour access to faster preauthorizations, member benefit information and network status details.

The online tool can be used to obtain a preauthorization for:

Preauthorizations for all levels of care may also be submitted by calling the number on your Humana ID card. Select “mental health” when prompted.

Telephone reviews must be completed for members with an eating disorder and for those seeking residential care, electroconvulsive therapy, applied behavioral analysis and transcranial magnetic stimulation.

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Covering the Cost of Treatment

The price of rehab ranges anywhere from $5,000 to $50,000, depending on various factors. Luckily, Humana helps cover the bulk of these costs. But you will be responsible for covering copays or any additional fees not covered by your plan.

In Network vs. Out of Network

The cost of treatment varies by plan. Those who choose a treatment center in network may pay substantially less than they would pay for an out-of-network provider. In-network providers have a contract with insurance companies to provide services to clients at a discounted rate.

If you go out of network for treatment, your costs may be much higher. But you may have to choose from an out-of-network facility if in-network centers are at capacity. A loan or finance plan could help you cover these costs.

You can find an in-network provider by calling the phone number on your Humana ID card.

Payment Assistance Programs

To reduce the cost of rehab, some treatment facilities offer payment assistance programs or sliding fee scales. Other rehab centers provide treatment free of charge, paid for by state taxes. State-sponsored programs generally have long waiting lists.

What Is Not Covered by Humana?

Humana offers a variety of health insurance plans. Each plan includes a list of prescription medications covered by Humana. Different plans may include different drugs. Medications may be added, changed or deleted from any list at any time.

The best way to verify your insurance coverage is to contact a Humana customer service representative. The representative can explain your plan in detail.

The Benefits of Treatment

Finding an in-network rehab center will help you avoid higher costs than those associated with an out-of-network facility. However, you also should ensure the treatment center provides evidence-based care that meets your specific needs.

Evidence-based rehab uses treatment approaches that have been medically proven to help people overcome substance abuse and co-occurring disorders. However, not all addiction rehabilitation centers treat these disorders simultaneously. For the best outcome, find a rehab facility that addresses all of your physical and mental health needs.

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