Find Rehabs That Accept Humana Insurance

Humana began its storied history of service not as an insurance provider but as a nursing home facility called Extendicare, which was launched in 1961 by David A. Jones Sr. and H. Wendell Cherry. By 1968, Extendicare had grown into one of the largest elder care provider networks in the country.

In the 1970s, the company transitioned from elder care to acute and general hospital care services. It was rechristened under the Humana brand in 1974. By the 1980s, Humana expanded its services once again to include managed care and health insurance coverage and by the 1990s, it sold its hospital interests. Today, Humana is one of the top health insurance providers in the US.

Does Humana Cover Drug and Alcohol Rehab?

Most Humana health insurance plans cover substance abuse treatment. The amount of coverage depends on your specific plan, the treatment you choose, and whether the drug or alcohol rehab is in-network or out-of-network.

Treatment generally starts with a visit to the primary care physician who can then seek authorization to refer you to a substance use treatment provider. To learn more about your coverage and any out of pocket expenses, call the number on the back of your insurance card to speak with a Humana representative.

Plans vary, but coverage often includes treatment options such as medical detox, inpatient or residential treatment, and outpatient care. You may also have coverage for medication assisted treatment, which is helpful for opioid and alcohol misuse.

Does Humana Cover Suboxone & Methadone?

Medication-assisted treatment (MAT) uses FDA-approved medications along with other therapies to treat addiction. Humana insurance coverage for MAT prescriptions, such as Suboxone and methadone, depends on your specific plan. You may need to choose a MAT provider that’s within the plan’s network to get the coverage you need.

Does Humana Cover Other Mental Healthcare?

Mental and behavioral health coverage is available for most Humana members. Humana plans pull from a network of 65,000 mental and behavioral health professionals. Many of Humana’s mental and behavioral health services are provided by the company’s subsidiary, Humana Behavioral Health.

Most Humana plans cover behavioral and mental health services. This can be very helpful since many people who struggle with substance use issues also have mental health concerns. Having both of these co-occurring disorders treated in an integrated way is essential for long term recovery.

Keep in mind that mental health, behavioral health, and substance use treatment may require preauthorization or a referral from your primary doctor before they will be covered by insurance. Before you enroll in a program, be sure to contact your insurance provider to verify coverage.

What Are Humana Plans and Coverage Areas?

Humana offers lots of plan types. You can look at individual or family plans in the Marketplace. If you qualify you can get Medicare or Medicaid plans from Humana. They also offer useful supplemental plans like vision and dental.

You can buy the supplemental through the Marketplace in your state or your employer might offer them. Since vision and dental aren’t part of most health plans, it can be helpful to have this coverage.

Humana offers Medicare Advantage plans (Medicare Part C). If you have Original Medicare you can buy your Part D drug coverage, a Medicare supplement (Medigap) plan or a special needs plan through Humana.

They also work with the state and federal government to provide Medicaid plans referred to as Humana Healthy Horizons. Participants can enroll through their state’s marketplace or through their state’s Medicaid agency.

Every state has their own eligibility requirements for coverage. These include: income guidelines, qualified medical conditions, pregnancy and age. Services covered will depend on what state an individual resides.

Humana offers Medicare plans in 49 states Washington DC and Puerto Rico. Their Medicare prescription drug plans are available in all states and include Washington D.C. and Puerto Rico. Humana Medicaid is available in Florida, Illinois, Indiana, Kentucky, Louisiana, Ohio, Oklahoma and South Carolina.

What Types of Inpatient Addiction Treatment Does Humana Cover?

Individuals requiring inpatient alcohol and substance use disorder treatment will need to meet medical necessity requirements. Covered services include medical detox, counseling services, and case management. Individuals should check with their insurance provider to determine coverage and what out of pocket expenses will be. Clients are often required to seek care at Humana participating facilities.

For individuals using the Humana Health Horizons (Medicaid) coverage differs from state to state. Verification of covered services is recommended and prior authorization may be required before services are initiated.

What Types of Outpatient Addiction Treatment Does Humana Cover?

When you attend a few hours of treatment a week but otherwise live at home that’s known as outpatient treatment. It could be an intensive program with more hours per week or a general one with fewer. You can also access aftercare services to stay on track outside of treatment. Outpatient rehab often includes individual and group counseling. Medication assisted treatment may be an option for those struggling with opioid or alcohol misuse.

For members with Humana Health Horizons covered services can differ between states and should be verified prior to seeking care. In many cases Humana will help individuals find participating facilities and providers for care.

How Much Does Addiction Treatment Cost With Humana?

Costs will depend on the type of Humana plan an individual participates in. It is important to check the benefits summary of your policy or contact a Humana representative to understand what services are covered and an estimated cost of out of pocket expenses. Many services will require prior authorization, medical necessity and Humana participating providers.

How to Verify Coverage With Humana

Individuals should check with their insurance provider by speaking with a care representative on the telephone or by logging into their online account to verify their coverage is active.

Through the online account an individual can check for in network providers and can utilize their care management professionals to assist in locating participating providers and facilities.

Additionally individuals can work with treatment centers to verify insurance plan participation and determine out of pocket expenses. It is important to have policy information available because coverage differs between Humana plans.

What to Do if Humana Won’t Cover the Full Cost of Rehab

Sometimes you’ll find that Humana covers some of the cost but not all of it when it comes to rehab. Other times the program you are interested in is not part of the network, so you have to pay out of pocket.

In a case like this, you can work with the treatment center to create a payment plan. Some centers also offer scholarships to those who need it. You can even apply for health credit such as CareCredit to pay the amount off over time. Finally you can find low cost or free treatment offered by nonprofits or your local community. Resources for these services can be found on SAMHSA website at SAMHSA.GOV.

What’s the First Step in Getting Addiction Treatment With Humana?

It is important for individuals to work with their health care providers to determine what is the best course for treatment to meet their unique needs. For those with insurance coverage many times prior authorization is required before obtaining care. For optimal coverage, you need to work with in network or participating facilities and providers.

Humana has resources on their website to aid in locating participating providers. Depending on what type of coverage an individual has they may provide case management services to help those with alcohol and substance use disorder locate facilities that accept Humana insurance.

For many individuals it is important to find programs that not only meet their treatment needs but recognize unique needs such as LGBTQ+, veterans issues, and spiritual/religious preferences. These should be considered when selecting a facility or provider.

Help in selecting appropriate services can be obtained by speaking with the facility or provider, researching different treatment centers, and by working with Humana case management to determine what will benefit you on their recovery journey.

Humana Insurance Coverage for Addiction Treatment