Humana Health Insurance: Does Humana Cover Rehab?

Humana Inc., a leading name in the American health insurance industry, held the No. 42 spot on the Fortune 500 in 2023, marking it as the highest-ranked company by revenues in Kentucky and the fourth-largest health insurance provider in the U.S.

With medical memberships extending to over 16 million people, Humana’s ample health plans include vision, dental, prescription drugs, and employer-provided group plans. If you have a Humana Health Plan, you can be confident that some of your drug rehabilitation expenses will be covered.

Read on to learn how Humana can assist in covering your rehab expenses, the specifics of your insurance benefits, and the steps to verify your coverage.

Table Of Contents:

• Humana Insurance Benefits
• Does Humana Cover Rehabilitation Treatment?
• Types of Humana Rehab Coverage
• How to Check My Humana Coverage?
• How to Use Humana Insurance for Rehab?
• Humana Rehab Centers and Coverage – Final Thoughts
• People Also Ask

Humana Insurance Benefits

As one of the largest health care providers in the country, Humana provides an extensive pool of services for individuals and families, groups, Medicare, dental, vision, and life insurance products. Whether you are a senior, a military member, a self-employed individual or a family head, Humana has different benefits to serve all types of clients.

Some benefits that may be included in Humana plans are:

• Annual benefits for routine vision exams, hearing exams, glasses and contact lenses.
• Some plans cover inpatient and outpatient mental health services.
• Some plans include fitness benefits through SilverSneakers (a fitness program for people with Medicare).
• Some plans include worldwide emergency care.
• Free auxiliary aids and services for people with disabilities (i.e., sign language interpreters).
• Some plans offer an allowance for eligible groceries, over-the-counter products, rent, and pet supplies.

Starting in 2024, all Humana Medicare Advantage plans will include routine dental, vision, and hearing benefits. Humana also offers plans that combine Medicare A (inpatient care), B (ambulance services), and D (prescription drugs) into one plan.

Does Humana Cover Rehabilitation Treatment?

The U.S. healthcare system has undergone significant transformation in recent decades, aiming to lower costs and improve outcomes for patients with chronic illnesses and disabilities.

The Affordable Care Act (ACA), also known as “Obamacare”, expanded insurance coverage, protected patients with pre-existing conditions, and introduced substance use disorders as one of the 10 elements of essential health benefits. Health insurance plans sold on Health Insurance Exchanges or provided by Medicaid must include addiction treatment services.

Anyone enrolled in a Humana plan can expect some level of support for addiction treatment. Still, the extent of coverage, types of treatments covered, and the specific details regarding deductibles and out-of-pocket costs can vary widely depending on your Humana plan and the state where you reside. Humana usually covers medically necessary services from a state-licensed substance abuse facility or hospital.

Does Humana Cover Alcohol Rehab?

Alcohol addiction falls under the umbrella of substance use disorders, which are recognized medical conditions requiring appropriate treatment.

Under the Affordable Care Act (ACA), health insurance plans, including those offered by Humana, must cover substance use disorder services. This means that if you have a Humana health plan, you may be eligible for coverage that includes various forms of alcohol rehab, from inpatient rehab treatment to outpatient counseling and support.

Coverage specifics can vary depending on your plan, so verifying your benefits and understanding your options is essential.

Does Humana Cover Psychiatrist?

Thanks to the Mental Health Parity and Addiction Equity Act (MHPAEA), health insurance plans must provide the same level of coverage for mental health and substance use disorders as they do for physical health conditions. This means that psychiatric care is likely included in your coverage if you have a Humana health plan.

The Affordable Care Act (ACA) also requires that insurance plans cover behavioral health issues, ensuring that individuals with behavioral addictions like gambling disorders or co-occurring disorders—like drug addiction plus depression—receive the necessary treatment.

Whether you are dealing with mental health issues alone or alongside a substance use disorder, Humana’s plans must offer you recovery support.

Types of Humana Rehab Coverage

Humana plans offer varying levels of coverage for addiction treatment depending on plan specifics and whether Humana health insurance providers are in-network. Common treatment types covered may include:

Humana Inpatient Rehab

This type of coverage includes intensive, residential treatment where patients stay at a facility for some time. It is ideal for those who need a structured environment with 24/7 medical and therapeutic support.

The cost and coverage for inpatient rehab vary by Humana plan. Since Humana inpatient requires prior authorization, discussing treatment options with your doctor before choosing a facility is crucial. While Humana only covers in-network providers, there’s no geographic restriction.

Most plans include copays (fixed amounts paid per service) and deductibles (yearly amounts paid before coverage kicks in)

Humana Outpatient Rehab

Outpatient rehab services allow individuals to receive treatment while living at home. This option is suitable for those with milder addictions or those who have completed inpatient treatment and need continued support.

Humana’s outpatient treatment coverage is similar to its inpatient coverage, with specifics determined by the health plan. Outpatient care is generally less costly and might have lower deductible impacts. Many Humana plans include prescription drug benefits, partially covering medication costs for outpatient addiction treatment. Traditional outpatient services don’t require prior authorization.

Humana Partial Hospitalization Programs (PHP)

Partial hospitalization is an intensive outpatient program providing structured psychiatric care. More comprehensive than traditional therapy, it aims to prevent full hospitalization.

It’s Humana’s highest level of treatment for dual diagnosis (mental health disorder and a diagnosed substance use disorder). PHP includes daily therapy sessions with a multidisciplinary team of mental health professionals, such as group, family, and individual therapy.

To receive coverage for PHP, patients usually need a referral from a mental health professional who can certify it’s medically necessary.  Humana also offers coverage for intensive outpatient programs (IOP).

Humana Detox Service

Detox is often the first step in the rehab process and is critical for safely managing the initial phase of recovery. Alcohol or drug detox is part of Humana’s emergency services aiming to evaluate or stabilize an emergency medical condition.

According to Humana’s guidelines, emergency care cannot be denied. However, subsequent days require pre-service authorization. Facilities must notify promptly, within 24 hours of emergency admission or discovery of member coverage.

Humana Drug Rehab Therapy and Counseling

Humana health insurance plans offer coverage for mental health services, including counseling. This coverage includes a variety of services, such as:

• Talk therapy
• Support group counseling
• Cognitive-behavioral therapy (CBT)
• Psychotherapy
• Dialectical behavior therapy (DBT)

• Crisis intervention
• Day treatment for children under age 21
• Drug and alcohol screening and assessment
• Peer support
• Psychological testing
• Therapeutic rehabilitation programs

Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT) is a comprehensive approach to treating substance use disorders. It combines medication, counseling, and behavioral therapies to provide a full treatment plan.

MAT addresses both the physical and psychological aspects of addiction. Medications for MAT are FDA-approved (methadone, buprenorphine and naltrexone) and help to reduce cravings, withdrawal symptoms, and the risk of overdose. Humana offers MAT treatment for opioid dependency (such as ordering and administering methadone), managing the care plan, and coordinating other substance use disorder services.

How to Check My Humana Coverage?

The easiest way to check your Humana drug rehab coverage is through your MyHumana account. Follow the steps to check your coverage online:

• Activate your MyHumana account: If you haven’t already, create an account on the Humana website.
• Human Login: Once logged in, you can access your plan details, including coverage information, deductibles, and co-pays.
• Contact Customer Service: You can call the number on the back of your Humana ID card for assistance.
• Review Your Plan Documents: Your Evidence of Coverage (EOC) will outline your plan benefits in detail.

If you have specific questions about coverage for a particular service or treatment, it is always best to contact Humana. They can provide accurate and up-to-date information based on your specific plan.

How to Use Humana Insurance for Rehab?

There isn’t a specific Humana plan designed solely for drug rehab. The key is to work with your current Humana plan.

Generally, the first step is reviewing your insurance policy to identify the covered rehabilitation services. This information is often found in the summary of benefits. Contacting Humana directly via their customer service line can also provide detailed information about your coverage, including any prior authorization requirements for rehab services.

Always choose in-network Humana rehab facilities or programs, as using these services may reduce your out-of-pocket expenses and overall drug rehab costs. If you have selected a rehab facility, coordinate with its admissions team to ensure they accept Humana insurance and facilitate the billing process.

Humana Rehab Centers and Coverage – Final Thoughts

While Humana provides coverage for various rehab services, the extent and nature of the coverage can vary significantly from one plan to another. Carefully review your policy details and consult with Humana representatives to understand what treatments are covered and to what extent.

If you find that your Humana plan doesn’t fully cover the addiction treatment services you require, don’t lose hope. Several rehab centers offer various payment options to ensure you can access the necessary treatment. These may include payment plans, sliding scale fees based on income, or even grants and scholarships.

Reach out to a local rehab center and let the staff help you find a way to afford the care you need!

People Also Ask

Is Humana the same as Medicare?

No, Humana is a private insurance company offering Medicare Advantage plans. These plans are alternatives to Original Medicare and provide additional benefits like dental, vision, and prescription drug coverage.

How long does Humana Medicare cover rehab after hospital stay?

Humana Medicare typically covers up to 100 days of skilled nursing facility rehab per benefit period after a hospital stay, with full coverage for the first 20 days and partial coverage for days 21-100.

How many days does Humana pay for rehab?

Humana health plans generally pay for up to 100 days of inpatient rehab in a skilled nursing facility per benefit period, subject to specific plan terms and facility rules.

Page Sources

1. American Medical Association. (2023, December 12). AMA identifies market leaders in health insurance. https://www.ama-assn.org/press-center/press-releases/ama-identifies-market-leaders-health-insurance
2. Statista. (2024, April 30). Medical membership of Humana in the U.S. 2008-2023. https://www.statista.com/statistics/210651/total-medical-membership-of-humana/
3. Substance Abuse and the Affordable Care Act. The White House. https://obamawhitehouse.archives.gov/ondcp/healthcare
4. Provider Manual Illinois-Humana Gold Plus Integrated Medicare-Medicaid (2022). https://docushare-web.apps.external.pioneer.humana.com/Marketing/docushare-app?file=4736537
5. Mancher, M., & Leshner, A. I. (2019, March 30). The Effectiveness of Medication-Based Treatment for Opioid Use Disorder. Medications for Opioid Use Disorder Save Lives - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK541393/