Does Humana insurance Cover Drug Rehab?
Humana is a health insurance company that provides coverage to approximately 17 million people.1 (p1) Although coverage depends on where you live, Humana offers a range of health insurance plans. They fall into 2 general categories:2 (Humana HMO plans, Humana PPO plans)
- Health maintenance organization (HMO) plans, in which you have to seek care through a network of approved doctors and facilities and cannot receive treatment from providers out of network. Humana drug coverage for prescription medication is included with the majority of these plans.
- Preferred provider organization (PPO) plans, in which you can see any provider you choose, although you’ll have lower out-of-pocket costs by staying in-network. Prescription medication coverage is included in some but not all of these plans.
If you aren’t sure about your Humana coverage, it’s easy to find out the details. You can contact a rehab center and speak with staff who can check your Humana insurance coverage and whether it is accepted at that facility. You can also call the number on the back of your insurance card to get more information about the specific plan you have, including whether you have a Humana drug insurance plan to help with the cost of prescription medications that may be used during treatment.
This page will help you learn more about:
- What substance use disorder services Humana health insurance covers.
- Whether Humana health insurance covers mental health services.
- How long treatment will typically be covered by Humana drug programs.
- What to do if you attend a rehab facility that isn’t covered by your insurance plan.
- The difference between attending an in-network and an out-of-network rehab facility.
- How to check your Humana rehab insurance coverage.
What Will Humana Insurance Cover?
Humana health insurance plans typically include coverage for behavioral health conditions, including substance use disorders.3 (some effective treatment options) Specific covered services depend on the plan you have. You may be covered for some or all of the cost of your treatment, including:3 (some effective treatment options), 4 (p4, 25-27)
- Inpatient care, where you stay at a facility for the duration of treatment while receiving structured, 24-hour support, and intense levels of group and individual counseling. Many inpatient facilities also offer detoxification services.
- Residential rehab, where you stay at a facility for a longer period of time and receive counseling, monitoring, and support so you can focus on living a more structured, substance-free lifestyle.
- Partial hospitalization programs (PHP), which is a bridge between inpatient and outpatient care. You live at home and participated in group and individual counseling for a significant part of the day.
- Intensive outpatient programs (IOP), where you live at home and receive group and individual counseling sessions that, while not as intense as a PHP, still provide more support than a traditional outpatient program.
- Outpatient treatment, where you live at home and attend fewer group and individual counseling sessions. You practice what you learn and receive feedback and support from staff and other participants.
- Medication-assisted treatment (MAT), where medication is used as part of your treatment plan to ease symptoms of withdrawal, reduce cravings, and help reduce the likelihood of relapse.
Does Humana Insurance Cover Mental Health Care?
Co-occurring disorders, when you have both a substance use and mental health disorder, are common.4 (p8) The best way to treat co-occurring disorders is through an integrated approach—that is, addressing both issues at the same time through the use of therapy and medications.4 (p8-9, 21), 5 (pe3) This way, substance use and mental health symptoms such as depression or anxiety are less likely to influence each other, and treatment is more likely to be effective.4 (p8), 5 (pe3), 6 (taking care) You are not limited to receiving treatment from Humana mental health providers; you can also work with a drug or alcohol rehab facility that can also treat co-occurring disorders.6 (how the behavioral health)
The Affordable Care Act identifies 10 categories of treatment—one of which is mental health care—as essential health benefits.7 Another important federal law is the Mental Health Parity and Addiction Equity Act, which requires group health insurance plans and health insurance companies that offer coverage for mental health and substance use disorders to provide coverage that isn’t any more restrictive than they provide for physical health conditions.8 (introductions, summary) This applies to annual or lifetime cost limits and treatment limits.8 (summary) While the limits and coverage can vary depending on your specific Humana plan, at least some rehabilitation coverage would typically be offered.
How Long Does Humana Insurance Cover Rehab?
Studies have shown that spending a longer period of time in treatment leads to better results.4 (p4, 12) A minimum of 90 days in treatment significantly impacts sobriety-related outcomes, with longer treatment stays being associated with an increased likelihood of long-term sobriety.4 (p4, 12) The length of time that you’ll be covered in a Humana drug rehab will depend on your individual needs, the progress you make in treatment, and the specifics of your insurance plan.4 (p4, 12) If you have questions about your plan coverage, call the customer service number on the back of your insurance card and speak to a customer service representative who can help you understand more about your plan and what it offers.
What If My Humana Policy Does Not Cover Heroin Rehab?
If your Humana program does not cover the rehab services you receive, there are some options to help you pay for treatment. Some facilities make treatment more affordable through scholarships or grants that cover all or part of the cost. You may be able to work out a payment plan or sliding scale fees. If these options aren’t available, you can utilize crowdfunding or loans to raise enough money to pay for your care. Keep in mind that attending treatment as early as possible is always your best option; delaying treatment can cost you more in terms of damage to your physical and mental health, social relationships, ability to work, and potential legal issues.
In-Network vs. Out-of-Network Rehab Centers
Generally, doctors or facilities contract with insurance companies to receive a specified rate for their services when seeing members of that healthcare plan. These providers are considered to be in network.9 (out of network liability) Healthcare providers who do not enter into this contract are known as out-of-network providers.9 (out of network liability)
If you have a Humana HMO plan, you are required to attend in-network Humana rehab centers or see in-network doctors in order for your treatment to be covered.2 (Humana HMO plans) If you have a Humana PPO plan, you can see either in-network or out-of-network providers, but staying in network will cost you less in copays.2 (Humana PPO plans) You can check whether a doctor or facility is in network or out of network by calling the number on the back of your insurance card. You can also visit this website to search for particular in-network providers or obtain a list of Humana mental health providers. Another option is to contact the provider and ask if they are in Humana’s network.
Check Your Benefits
American Addiction Centers is the foremost provider of treatment for substance use disorders and co-occurring disorders in the United States, with facilities located across the country. Our treatment programs are customized to meet your individual needs and set you up for long-term success and sobriety.
We can help you find a facility that accepts your Humana insurance plan so you can get on the right path to overcoming your addiction. Enter your insurance information to immediately see if your insurance plan will cover your treatment at an American Addiction Centers facility. You can also call our free, confidential helpline 24/7 at 1-888-851-2649 Who Answers? . You’ll speak to a knowledgeable, compassionate associate who can check your benefits while you’re on the phone and answer any questions you may have about treatment.
Let’s verify your coverage for treatment at an American Addiction Centers location. Your information is always confidential.
- (2020). 2020 Annual report.
- (2021). Humana Medicare Advantage plans.
- (2021). Don’t let substance use disorders have the last word.
- National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (Third edition).
- Yule, A.M., & Kelly, J.F. (2019). Integrating treatment for co-occurring mental health conditions. Alcohol research: Current reviews, 40(1).
- Humana Behavioral Health. (2015). Behavioral health benefits.
- gov. Essential health benefits.
- Centers for Medicare and Medicaid Services. The Mental Health Parity and Addiction Equity Act (MHPAEA).
- (2021). Healthcare plan rules explained in plain language.