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Humana Health Insurance for Addiction Treatment

Humana healthcare provider is one of the largest health insurance providers in the United States. With over 13 million members, Humana offers a wide array of policy options and essential health benefits to meet the specific needs of its members. These include services for substance abuse/mental health services/behavioral health services. Most of these policies have addiction treatment coverage, however, the amount of coverage will vary between health insurance plans.

When mental health is neglected, prolonged physical health problems can arise, drastically affecting an individual’s overall quality of life. Humana provides insurance plan options that can address a mental health condition through various treatment options within a wide network.

Navigating insurance coverage for rehab can be stressful. If you’re worried about how you’re going to pay for addiction treatment, know that there are numerous ways to cover the costs associated with treatment, such as through payment plans. Additionally, the Affordable Care Act made it mandatory for insurance companies to provide coverage for alcohol addiction treatment and other mental health conditions. As a result, you might have improved access to behavioral health treatment. This includes Medicaid, Medicare, private coverage, military insurance, and state health insurance. If you qualify, these options, coupled with other insurance types, can assist you in additional financial support for alcohol rehab. To see if your insurance will pay for your treatment, check your insurance coverage here.

Addiction Treatment & Mental Health Coverage with Humana

Humana health insurance can include various services for addiction treatment. The exact type of addiction treatment coverage each member has will depend on a few factors, including the specific insurance policy, the state in which the member lives and is choosing to seek treatment within, whether or not there are legal requirements, and the level of care the member is going to begin treatment with.

Most Humana mental health care plans cover the following addiction treatment services:

  • Outpatient Detox
  • Inpatient Detox
  • Inpatient Rehab
  • Residential Treatment
  • Partial Hospitalization Program (PHP)
  • Intensive Outpatient Program (IOP)
  • Group Therapy
  • Individual Therapy
  • Psychiatric Evaluation and Management
  • Medical Evaluation and Management
  • Assessments and Screenings
  • Wellness and Prevention Services

Unfortunately, not all Humana insurance policies have behavioral health benefits provided under their coverage. However, these benefits can be purchased as an add-on to the individual policy. Regardless of the plan, for a member to be covered for substance abuse treatment, there must be a medical necessity, and the provider must obtain authorization for the treatment services.

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Addiction Resources with Humana

Humana Behavioral Health, a subsidiary of Humana, offers addiction resources to its members through a 24/7 helpline and easy access to participating providers. Humana takes pride in being an advocate for their members, providing assistance to members with any questions or concerns they may have, and providing case management in cases of multiple hospitalizations and behavioral health needs that require frequent or ongoing assistance.

Addiction Treatment Coverage with Humana

Addiction Treatment Coverage will vary with each Humana policy, the state in which the member lives and is choosing to seek treatment within if there are legal requirements, and the level of care the member will begin treatment within. Unfortunately, not all Humana plans have substance abuse coverage; however, it can be purchased as an add-on to the individual policy. Regardless of the plan, for a member to be covered for substance abuse treatment, there must be a medical necessity, and the provider must obtain authorization for the treatment services.

Most Humana plans cover the following addiction treatment services:

  • Inpatient Detox
  • Inpatient Rehab
  • Residential Treatment
  • Partial Hospitalization (PHP)
  • Intensive Outpatient (IOP)
  • Group Therapy
  • Individual Therapy
  • Psychiatric Evaluation and Management
  • Medical Evaluation and Management
  • Assessments and Screenings

Does Humana Cover Mental Health Services?

Yes. As mentioned, mental health services, including addiction treatment services, are available with Humana health insurance plans.

Does Humana Cover Out-of-Network Treatment?

Depending on the plan, Humana might cover out-of-network treatment at the member’s selected hospital or medical facility. Those with Humana HMO plans will be required to seek treatment within the Health Maintenance Organization, an in-network provider. Members with Humana PPO policies are able to seek treatment both in and out-of-network, widening their treatment options and allowing them to find a treatment facility that meets their individual treatment needs.

When seeking addiction treatment and mental health care with an out-of-network substance use disorder treatment provider, members might face higher costs than if they were to seek treatment with an in-network provider. Treatment is subject to a higher out-of-network deductible, coinsurance, and maximum out-of-pocket costs, as well as any additional costs that might be due to the provider.

Inpatient Mental Health Treatment Coverage with Humana

Inpatient Treatment Coverage with Humana is dependent on the plan. Some plans may not offer coverage, others may offer coverage only within the network or with a high out-of-pocket cost for out-of-network providers. All inpatient treatment services will require prior authorization to ensure coverage of treatment.

Commonly covered inpatient services by Humana health insurance include but are not limited to:

  • Screenings and Assessments
  • Psychiatric Evaluations
  • Individual Therapies
  • Medical Examination and Treatment
  • Detoxification
  • Inpatient Rehab Stay
  • Aftercare Services

To determine your inpatient treatment coverage, contact Human Behavioral Health member services.

Outpatient Services for Mental Health Treatment with Humana

Humana Behavioral Health policies cover a wide array of outpatient treatment services. Depending on the policy, these services may be received with an in or out-of-network provider. Unfortunately, most Humana policies exclude court-ordered outpatient treatment. Depending on the level of outpatient care, there may be prior authorization requirements for treatment services.

Commonly covered healthcare services for outpatient treatment can include:

  • Partial Hospitalization (PHP)
  • Intensive Outpatient (IOP)
  • Group Therapy
  • Individual Therapy
  • Psychiatric Evaluation and Management
  • Assessments and Screenings

Addiction Treatment Costs with Humana

The cost of addiction treatment with Humana will be determined by the specific plan. Typically in-network treatment will have a copay, members may be required to pay a deductible depending on the level of care. Out-of-network treatment requires the member to pay an out-of-network deductible; once that is met, the member will be responsible to pay a coinsurance amount until they meet their maximum out-of-pocket, at which time Humana will begin to cover the member at 100%. With out-of-network treatment providers, the member may also incur additional treatment costs.

To determine your out-of-pocket costs for addiction treatment, contact our rehab advisors. We are here to help you maximize your plan’s benefits and minimize your out-of-cost expenses.

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If you or a loved one are ready to overcome drug or alcohol abuse, our addiction specialists are here to guide you through every step. Many of our dedicated staff members are in long-term recovery themselves and understand firsthand the challenges of the recovery journey. This personal experience, combined with our professional expertise, allows us to offer compassionate, effective support tailored to your unique needs.
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Addiction Resources & Mental Health Services with Humana

Humana Behavioral Health, a subsidiary of Humana, offers addiction resources to its members through a 24/7 helpline and easy access to participating providers. Humana takes pride in advocating for its members and providing assistance to members with any questions or concerns they might have regarding their policy, addiction treatment, and mental health benefits. They also provide case management in cases of multiple hospitalizations and behavioral health needs that require frequent or ongoing assistance.

Dr Kate Smith

Clinical Reviewer

Dr. Kate Smith is a licensed professional and has worked in the mental health and substance abuse disorder fields for over 10 years. She earned her bachelor’s degree in Social Work from Florida Atlantic University, graduating magna cum laude from her class. She obtained her Masters in Social Work (MSW) at Barry University in an accelerated program.

More about Dr. Kate Smith

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Quit Alcohol’s helpline is a private and convenient solution for those seeking treatment for addiction or mental illness. Calls to our helpline (all non-facility specific numbers) will be answered by a caring rehab advisor from Treatment Addiction Solutions or one of our verified treatment partners. Calls are routed based on geographic location and will help you navigate:

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