Rehab Centers That Accept Humana Insurance

Humana, an insurance company contracted with Medicare, insures millions of people in the United States each year. Many policyholders use their coverage to help pay for substance use treatment and addiction therapy. Having a better understanding of Humana’s rehab coverage and how it works can help you choose the right treatment facility and level of care for your needs.

Humana covers drug and alcohol addiction treatment, thanks to the Affordable Care Act (ACA). Signed into law in 2010, the ACA lists substance abuse as one of 10 essential health benefits. This means any insurance policy sold on the Health Insurance Exchange must cover addiction treatment services.

However, there are limitations, and health insurance coverage is contingent on factors such as your specific plan, medical needs and location. To verify the details of your specific coverage, you can contact the customer support team at 800-457-4708 or log into the MyHumana portal.

Humana covers a range of treatment programs for substance use disorders (SUDs). What your policy pays for depends on the program’s network status and what’s medically necessary but could include any of the following services.

Medical Detox

Medical detoxification, or detox, is often the first phase of treatment. This is when the body is able to get rid of any remaining addictive substances and when withdrawal symptoms normally peak. Clinicians monitor your vitals and administer medication to keep you comfortable and ensure you detox safely.

Humana health insurance plans cover medical detox services, but prior authorization may be required. Some detox services may be covered under regular medical care, while others may be part of your behavioral healthcare coverage. You may also be responsible for a co-pay or coinsurance.

Medication-Assisted Treatment

Medication-assisted treatment (MAT) is a rehab service that uses medications approved by the U.S. Food and Drug Administration (FDA) to treat substance use disorder. MAT is tailored to the individual and can help manage withdrawal symptoms, such as cravings, and reduce the risk of relapse post-treatment.

Most Humana plans offer coverage for MAT, either as regular medical treatment or under mental health benefits. Prior authorization may be required, and the medication itself is likely to fall under prescription drug benefits, which may have a separate co-pay and deductible.

Inpatient Rehab

Many people start with inpatient treatment, also known as residential treatment, because it offers a structured schedule and 24-hour support, which can be helpful in the early stages of recovery.

Humana insurance covers inpatient rehab, but you may need to attend an in-network program, and certain services may be excluded. There may also be limits on how long you can stay in the facility.

Humana’s coverage for inpatient care generally includes room and board, skilled nursing services and medically necessary therapies. Amenities or holistic services, such as chiropractic care, may not be covered.

Dual-Diagnosis Treatment

When you have an SUD and a mental health condition at the same time, it’s called a dual diagnosis or a co-occurring disorder. Untreated mental health disorders are often the root of addiction, as many people use substances as a way to self-medicate and reduce their symptoms. Ongoing substance use can also increase the likelihood of developing a mental health disorder.

In dual-diagnosis programs, you receive treatment for your mental health issues and substance abuse at the same time and receive services, such as behavioral therapy and counseling. Humana covers dual-diagnosis care as part of its mental health coverage, but prior authorization and a co-pay may apply.

Outpatient Treatment Programs

People often step down to partial hospitalization programs (PHPs), intensive outpatient treatment (IOP) or standard outpatient care after completing residential rehab. You attend rehab several days a week for a set amount of hours and return home in the evenings.

Humana plans cover outpatient substance use treatment programs, which can include medical and behavioral health care services. The required co-pay can differ, depending on whether the program is at a hospital, at a specialist’s office or administered through telehealth.

Counseling and Behavioral Therapy

Counseling and behavioral therapy are critical parts of recovery. Common options for substance use include cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT). Humana plans cover addiction-related therapy under mental health services, and a co-pay may apply.

Continuing Care

Continuing care, also known as aftercare, refers to any addiction treatment services provided after completing a treatment program. Aftercare differs from person to person and may include therapy, support groups or sober housing.

Humana insurance coverage for continuing care services varies by policy. For example, therapy is covered, but rent for sober housing may not be because it’s not a clinical service. You can check your benefits for continuing care by calling Humana directly or logging in to the customer portal.

The primary factors that affect how much Humana insurance covers for substance abuse rehab are the type of treatment you need and what policy you have. In most cases, insurance only covers medically necessary clinical care. If you want to go to a holistic rehab center or are interested in alternative treatments, your options may be limited, and you may have to pay more out of pocket.

Your policy will outline which types of care are covered and whether you can see out-of-network providers or must stay within the insurance company’s preferred network. Your Summary of Benefits will also explain whether you need prior authorization or a referral to get coverage for substance use treatment and what your co-pays and coinsurance are for inpatient and outpatient services.

Whether Humana covers out-of-network substance use treatment depends on your policy. For example, Preferred Provider Organization plans (PPOs) provide out-of-network coverage, but you’ll pay more out-of-pocket for co-pays and coinsurance.

Other plans, such as Health Maintenance Organizations (HMOs), only cover care from in-network providers. In-network providers have a contract with Humana that negotiates lower rates, resulting in lower out-of-pocket costs. You can contact Humana or use your patient portal to find in-network rehab programs.

Depending on where you live or whether you’re getting insurance through an employer or the Healthcare Exchange, you may have a choice between a couple or several different plans. Humana offers:

• Health Maintenance Organization (HMO) plans
  • Humana Gold Plus
  • Humana USAA Honor
• Preferred Provider Organization (PPO) plans
  • Humana USAA Honor
  • HumanaChoice
• Special Needs Plans (SNPs)
• Private Fee for Service (PFFS) plans
• Medicaid plans

You can select the plan that best suits your needs based on premiums, co-pays, deductibles and out-of-pocket maximums.

Coverage for addiction treatment through Humana insurance isn’t based on what kind of addiction you have or what substances you use. As long as you find a provider that accepts Humana insurance, treatment for substance use disorder, behavioral addictions and mental health disorders should be covered.

To find a treatment center that accepts Humana insurance near you, call the Humana customer service line or use your patient portal. Once you’re signed into MyHumana, select “Find a doctor or pharmacy.” You can search for “addiction treatment” or “substance abuse rehab.” From there, you should receive a list of rehab providers in your area that are covered by your Humana insurance plan.

Your healthcare provider or primary care physician may be able to refer you to specific rehab centers if you need additional guidance. RehabNet.com also offers a list of substance abuse facilities by state, including what insurance each center accepts.

If you find a treatment facility on your own and aren’t sure whether it’s in-network, you can search for the provider in your portal or call the Humana Behavioral Health Hotline at 833-801-7355 to speak with a navigator.

Reaching out for help is the first step in recovery. Support is available to help you connect with a drug and alcohol rehab program that fits your needs and is covered by your insurance. Whether you’re ready to move forward with addiction recovery or you have more questions about Humana rehab coverage, contact our free, confidential helpline to talk to someone who can walk you through the next steps.