Humana Insurance Coverage for Rehab | Withdrawal.net

Humana Insurance Coverage for Rehab and Detox

Humana offers coverage for detox and rehab through a variety of employer, Medicaid, Medicare, and TRICARE plans. Read on to learn more.



Does Humana Insurance Cover Rehab?

Like most insurance plans, Humana insurance plans cover some form of substance abuse treatment as the Affordable Care Act of 2010 requires insurance providers to provide addiction treatment as an essential benefit. However, the amount your Humana plan will pay for detox or rehab will depend highly on the type of plan you are enrolled in.

How to Use Humana Insurance to Pay for Rehab

In order to use your Humana coverage for addiction treatment, you’ll need to check your benefits, gather any documentation required under the terms of your plan, and find a treatment center that accepts Humana coverage.

Many detox and rehab centers are able to check your benefits quickly and explain your benefits to you. While this may be convenient, you should always confirm with Humana before attending treatment.  To check with Humana directly on the details of your plan, you can:

  • Call Humana member services directly
  • Login to Humana’s online member services portal

Next, you’ll need any documentation required by your plan before admitting to treatment. The most common documentation required is known as “prior authorization.” In short, like most insurance providers, Humana will have to approve a specific treatment or medication before it is covered.

If you understand your benefits and have the documentation you need to begin treatment, the next step will be finding a treatment center that accepts Humana. For more questions about how to find a treatment center that accepts Humana in your state, select your state from the list below.

Types of Addiction Treatment Covered by Humana Insurance

The types of treatment covered by your Humana plan will depend on the type of insurance you have, where you attend treatment, whether the treatment is deemed medically necessary, and how long and intense the treatment is. Your Humana plan may cover services like:

Types of Humana Insurance Plans

Humana has private insurance plans that are offered through some employers.2 These are generally standard healthcare plans that require you to pay a deductible and then 20% of the remaining cost of a rehab stay. Like most plans, if you go through the Humana rehab provider network, your costs are generally lower. If you chose to go outside of the network, you may pay significantly more for rehab and detox. Some employers may offer lower-cost plans with higher deductibles, while others may offer higher premiums with lower deductibles and co-pays.

Humana with Medicare and Medicaid

Humana also offers Medicare advantage plans. These plans vary from one state to another in terms of medical cost coverage and the amount of co-pay for hospitalization. For example, in South Carolina, the Humana Gold Plus Plan for Medicare requires that you pay $465 per day for the first 4 days of inpatient treatment by in-network providers who accept Medicare, with no further payment for up to 90 days. Another Medicare plan, the Humana Choice PPO, requires you to pay $298 for the first 7 days of inpatient treatment at a Medicare-approved rehab facility or hospital, and nothing after that. However, in California, the Humana Gold Plus Plan has no co-pays for hospital stays. The Humana Value Plus plan requires that you pay $480 per day for the first 3 days and then nothing after that.

Humana is also a provider of managed Medicaid plans in Florida, Illinois, and Kentucky. Under these Humana plans, rehab providers who accept Medicaid will cover most of the cost of rehab or detox.3

What is TRICARE?

If you are covered under TRICARE, your program is managed by Humana Military in the eastern section of the United States. Tricare coverage varies from one type of Tricare plan to another. Under Tricare Prime, for example, you would have no out-of-pocket costs for outpatient or inpatient rehab or detox at an approved provider facility.

How Much Does Humana Cover?

The Affordable Care Act requires health insurance plans, like the ones offered by Humana, to provide some degree of coverage for the medically necessary treatment of mental and behavioral health disorders. This will oftentimes include some degree of coverage for the treatment of substance use disorders. However, your Humana health insurance plan may not cover the entire cost of treatment. Factors that may cause coverage to vary include:

  • What type of Humana insurance plan you have.
  • Where you receive treatment.
  • Whether a facility is in-network with Humana.
  • Intensity of treatment.
  • Length of treatment.
  • Accommodations and amenities offered by facility.

It’s important to reach out to a Humana representative before committing to treatment to check your insurance coverage.

Do Rehab Centers Need to Be In-Network with Humana?

In order to take full advantage of the benefits offered by your Humana insurance plan, you’ll likely need to attend treatment at an in-network facility. While you may still attend treatment at an out-of-network facility, your Humana benefits may be significantly reduced, resulting in greater out-of-pocket costs. It’s a good idea to reach out to any prospective rehab center to determine if they are in-network with Humana.

Finding Alcohol or Drug Rehab That Take Humana Insurance

Once you’ve decided to commit to treatment you’ll need to find a rehab that accepts Humana insurance. A good place to start would be to reach out to your Humana representative to verify your coverage. Understanding what your benefits are can help you determine what treatment facilities will work for you. They may also be able to refer you to rehabs in your area. Once you’ve verified your coverage, you may want to visit the SAMHSA treatment locator to find a rehab near you.

Additionally, you may consider reaching out to an addiction helpline. Addiction helplines, like the one owned and operated by American Addiction Centers, are 24/7 resources that can help answer questions you may have about rehab or insurance. If you want to check your Humana insurance benefits, reach out to us at or text us today.

How to Check my Humana Benefits

If you still have questions about the cost of treatment after using your Humana coverage, many rehab centers offer confidential substance abuse or detox hotlines dedicated to answering questions. Some rehab providers, like  American Addiction Centers (AAC), allow you to check your coverage at their facility online. To see if your Humana plan is accepted at AAC, complete the form below.




Does your insurance cover treatment? Check your coverage online instantly.
Instead, sign up for text support to receive:
  • You will receive results in minutes.
  • There is no obligation to enter treatment.
  • Your information is protected under HIPPA.

* These fields are required

*
John
*
Smith
*
(555) 555-5555
*
jsmith@mail.com
MM/DD/YYYY
Aetna
WXY1030Z0
Disclaimer
HIPAA badge