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Published: August 14, 2023
Humana, an insurance company contracted with Medicare, insures roughly 17 million people in the U.S. Many Humana policyholders get rehab coverage every year to help them seek addiction recovery.
If you or your loved one receives insurance through Humana, keep reading to learn all about Humana health insurance treatment coverage for substance abuse treatment.
Answer: Yes, Humana does cover drug and alcohol addiction treatment thanks to the Affordable Care Act (ACA).
As a disclaimer, keep in mind there are limitations and specifications to health insurance coverage that will be contingent on variables like your plan, location, and more.
Signed into law in 2010, the ACA lists substance abuse as one of 10 essential health benefits. In other words, this means that any insurance provider sold on Health Insurance Exchanges must include addiction treatment services.
Answer: Humana covers a range of treatment programs for substance use disorder (SUD) treatment, with a variety of health services.
Depending on your needs and goals, you may want to choose a specific type of treatment service to start your journey.
You may be able to get the following treatment options covered through your Humana healthcare plan.
Most Humana health insurance plans will cover at least a portion of medical detox services. Some plans will require a copay while others may require coinsurance.
Medical detoxification, or detox, is an evidence-based service that is provided at the start of a treatment program. Detox helps rid the body of any remaining addictive substances while managing withdrawal symptoms.
In addition to helping you get through withdrawal, detox services also monitor your vitals and administer any necessary medications to ensure you detox safely.
Many Humana plans offer some coverage for MAT, but may require prior authorization.
Medication-assisted treatment, often referred to as MAT, is a rehab service that uses U.S. Food and Drug Administration approved medications to treat SUD.
MAT is a very tailored-to-the-individual type of service, as your treatment provider will determine the appropriate medication dose for your needs. This type of care can help manage withdrawal symptoms like cravings and reduce the risk of relapse post-treatment.
Inpatient treatment is often covered to some extent by Humana insurance plans, but many require a copay.
Inpatient rehab is treatment that takes place in a designated facility where participants stay for the entire program. Inpatient treatment offers an intensive level of care with a structured regimen and 24-hour supervision.
Many people start with inpatient treatment and later step down to other services like outpatient rehab. Inpatient rehab combines several different treatment approaches including therapy, group counseling, and more.
Similar to inpatient treatment, coverage for dual diagnosis treatment through Humana is dependent on your plan, but many offer some coverage.
Dual diagnosis treatment refers to the treatment of addiction alongside simultaneous mental health disorders, known as co-occurring disorders. Co-occurring disorders are often the root of addiction.
In dual diagnosis programs, you can expect to receive treatment for your mental health issues and addiction through services like behavioral therapy and counseling.
Humana plans that offer coverage of outpatient treatment often require a copay for each visit to the outpatient treatment center. The details of this coverage will differ between plans, however.
Outpatient treatment may be considered to be a step down from inpatient treatment. This is because outpatient programs do not require individuals to stay in a treatment center throughout their treatment, but rather, to travel to a rehab facility several days a week for a set amount of hours.
Aside from traditional rehab, outpatient programs can also include programs like partial hospitalization programs (PHP) or intensive outpatient programs (IOP).
Most Humana plans cover addiction-related therapy. If the therapy is provided through an inpatient or outpatient program, it will depend on the coverage offered for that type of program.
Counseling and behavioral therapy are two facets of talk therapy often used in different addiction treatment programs. Counseling focuses more on talking with a professional or group about your emotions and concerns throughout your recovery journey.
On the other hand, behavioral therapy is talk therapy that focuses on changing an individual’s behavioral and thought patterns. Some commonly offered behavioral therapy options include cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT).
Coverage for continuing care will depend on the kind you receive. For example, support groups may be free to attend within a community whereas sober living requires rent payments. Sober living is covered by some Humana plans.
Continuing care, sometimes referred to as aftercare, is any addiction treatment service that is continued after completing a treatment program.
Aftercare differs from person to person, as it is a very individualized approach, but it may include therapy, counseling, support groups, or sober housing.
There are a number of factors that affect Humana insurance coverage for SUD treatment, and all of these factors will be taken into consideration to determine if your plan covers treatment.
Factors that affect coverage include:
Answer: No, Humana does not cover out-of-network rehab programs. If you choose to receive treatment through an out-of-network provider, you can expect your out-of-pocket costs to be much higher than if you were to get treatment in-network.
This is because in-network providers have a contract with Humana that negotiates lower rates, resulting in lower out-of-pocket costs.
To avoid seeing an out-of-network addiction rehab provider, speak with Humana and use your patient portal to find rehab programs that are in the network.
Humana offers various different plans including:
Depending on the area in which you live, you may have a choice between a couple or several of these plans. You can select the plan that best suits your needs based on premiums, copays, deductibles, and out-of-pocket maximums.
Coverage for addiction treatment through Humana insurance is not determined based on the type of addiction you have.
As long as you find a facility that accepts Humana insurance, they will likely cover treatment for your addiction as most treat the most common kinds of addiction.
Types of addiction you may get covered include:
To find a treatment center that accepts Humana insurance near you, you can start by utilizing your patient portal.
First, sign into MyHumana and select “Find a doctor or pharmacy.” You can then search addiction treatment or substance abuse rehab.
From here, you should receive a list of rehab providers in your area that are covered by your Humana insurance plan.
If you find a treatment facility outside of your patient portal, you can always search the provider in your portal or give the Humana Behavioral Health Hotline a call and speak with a navigator. The number can be found on the back of your insurance card.
Your healthcare provider or primary care physician may also be able to refer you to specific rehab centers if you need additional guidance.
Lastly, be sure to check out our list of substance abuse facilities by state. Here, you’ll find information about accepted insurance providers at each center.
Humana is a widely used insurance provider that provides coverage for certain addiction rehab services depending on the plan you have and the facility you choose.
If you’re ready to take your first step in addiction recovery, or have more questions about Humana rehab coverage, give our phone number a call today.
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