Humana Drug Rehab

Humana is a large health insurance provider in the United States that offers a range of health plans that cover inpatient and outpatient drug and alcohol rehabilitation services. Exact coverage and benefits for addiction treatment vary from plan to plan, and coverage may not be available on all plans. ^[1]If you would like to find out what your Humana health plan covers in terms of treatment for substance abuse, please call the National Drug Helpline at 1-844-289-0879 at any time of day or night.

Humana: Company Overview

Humana is a Fortune 500 company with its headquarters in Louisville, Kentucky. The company was founded in the 1960s with a focus on nursing homes. It grew rapidly over the next three decades, going on to become the largest hospital operator in the country. The name Humana was incorporated in the mid-1970s to reflect a higher level of healthcare and a human approach to medicine. In the 1980s, Humana created its first health insurance plan and has grown from strength to strength since then.

Today, Humana Inc. is one of the largest health insurance companies in the United States, with more than 13 million members (2014 figure) and annual revenues above $41 billion (2013). Humana offers a variety of health plans to meet the healthcare needs of its customers. Most Humana plans include coverage for addiction treatment at least partially, but the type and amount of coverage vary from plan to plan.

Humana Resources for Substance Abuse Treatment

Through its subsidiary Humana Behavioral Health, the company offers a range of addiction and mental health services and resources. People struggling with substance use disorders can use these resources to access healthcare providers, coordinate treatment, and get answers to their questions. Humana Behavioral Health also does advocacy for its customers in dealing with providers. Case managers help members with ongoing assistance for multiple addiction treatments and behavioral health needs. Confidentiality is assured according to state and federal laws.

Humana Treatment Coverage for Substance Use Disorders

Coverage for addiction treatment and rehabilitation services with a Humana health plan depends on various factors, including the individual plan details, the customer’s state of residence, and the type of treatment necessary. To receive treatment for drug or alcohol addiction under a Humana plan, it must be deemed medically necessary and specified as covered by that specific plan. Customers whose Humana plan does not include substance abuse treatment have the option of purchasing separate coverage for addiction treatment. Some of the substance use disorder treatment options that may be covered by Humana health plans include:

Inpatient detoxification: This involves staying at a residential facility while the body rids itself of drugs or alcohol. Inpatient detox is typically necessary to stabilize people with severe, longstanding addictions.

Outpatient detoxification: A team of medical professionals monitors the patient during the detox program, which is administered during the day, allowing the person to return home at night.

Inpatient rehabilitation: People with a history of long-term or heavy drug abuse typically need to stay at a residential rehab facility for several weeks. This is a structured program that gives clients the best chance of recovery, with intensive therapy and 24/7 monitoring.

Outpatient rehabilitation: Those who have milder substance use disorders can undergo therapy several times a week at a clinic, hospital, or rehab facility while living at home and continuing to work.

Medication management: Certain drug addictions can be treated effectively with medications. For instance, there are medications available to treat opioid use disorders. One such medication, methadone, is given through special clinics that are strictly regulated by state and federal laws. Depending on the specific Humana health plan, treatment at a methadone clinic may or may not be covered.

Humana Health Plans

Humana does not offer any gap insurance, medical indemnity, or short-term plans. However, the company does offer a range of dental plans, Medicare plans, vision plans, and business plans.

Humana dental plans typically cover routine and preventive dental care, although specific benefits vary by plan. Basic dental care usually includes oral exams, fillings, cleanings, and X-rays. You can choose a Humana HMO dental value plan for low monthly premiums, or a PPO (preferred provider organization) dental insurance plan for greater flexibility.

Humana vision insurance plans usually include an annual vision exam and a yearly allowance towards eyeglasses or standard contact lenses with a minor co-pay. Your Humana vision plan may also give you discounts on frames and contact lenses. Choosing an in-network eye doctor from Humana’s extensive network of providers can result in lower costs for quality vision care. Some plans may include specialized diabetic eye care at no additional cost.

Humana Medicare plans may include hospital, medical, and prescription drug coverage. For example, the Humana Medicare Advantage Plan is an all-inclusive plan that includes coverage for prescription drugs. Members have the security of a maximum yearly out-of-pocket expense. Many Humana Medicare plans offer routine vision, dental, and hearing care with a $0 premium. ^[2]

Humana has a range of group health insurance plans for employees of small businesses. These budget-friendly health plans offer medical, vision, and dental care coverage as well as life insurance, wellness, and group Medicare.

Understanding Common Insurance Terms

When you are choosing a Humana health plan, it helps to know some of the common insurance terms used in the policy descriptions.

In-network and out-of-network: Humana has contracted with certain healthcare providers and drug and alcohol treatment facilities and negotiated lower rates with them. When you choose to be treated at an in-network drug rehab facility, you will typically pay less compared to treatment at an out-of-network rehab center that has not agreed to discounted rates with Humana.

Allowable charge: Also called the allowed amount, this is the usual, customary, and reasonable charge for a particular service allowed by a health insurance company based on typical rates in the area.

Deductible: This is a fixed amount you must pay towards your medical expenses before your insurance company starts paying.

Coinsurance: This is a shared cost of healthcare services after you have met your deductible. It is usually expressed as a percentage. For instance, the insurance company may pay 80% of a claim, and you will be responsible for the remaining 20% of your medical bills.

Co-payment: Like coinsurance, the co-pay is another way of sharing the cost between you and your health plan provider. It is usually a fixed dollar amount for certain types of healthcare expenses. For instance, you may be required to pay $25 for each outpatient doctor’s visit, while the insurance company will pay the rest.

Out-of-pocket maximum: This is the most you will pay for healthcare during a year. It includes deductibles, coinsurance, and co-payments, but it does not include your monthly premium. Once you reach your out-of-pocket maximum, the insurance company will pay all your medical expenses for the rest of the year. For example, if you have a Humana health plan with an out-of-pocket maximum of $5,000, you can have peace of mind that whatever your healthcare events during a year, your medical expenses will be capped at $5,000.

Drug formulary: This is a list of prescription medications covered by a specific health plan. If you need regular prescriptions of certain medications, you should check whether that medication is on the drug formulary of your Humana health plan.

Health maintenance organization (HMO): This is a health financing system in which the member receives comprehensive health services through specific in-network providers. A Humana HMO plan can give you coordinated medical care with a predictable cost, including preventive care and referrals to in-network specialists.

Preferred provider organization (PPO): A Humana PPO health plan gives you more flexibility to choose from a broad network of both in-network and out-of-network providers. Costs are lowest when you seek care from in-network providers. However, you do have the choice of seeing an out-of-network provider if you want.

Health savings account (HSA): This is a personal savings account that allows a person to pay for medical expenses with pre-tax dollars. The account complements what are known as HSA-qualified HDHPs (high-deductible health plans). HDHPs have a lower monthly premium than traditional health plans. Customers invest the money they save on monthly premiums in an HSA to pay for future eligible healthcare expenses.

Addiction Treatment with Humana Health Plans

Choosing a Humana health plan can seem complicated, but there are a few things to keep in mind that can make it easier. It’s important to think about both your monthly premium and your out-of-pocket expenses, such as the deductible, co-pay, and coinsurance, should you need medical care. In terms of addiction treatment, not all Humana plans cover treatment at out-of-network rehab facilities. Even if drug rehab at an out-of-network center is covered by a Humana health plan, it will generally invite a higher deductible and co-pay. Also, new-age therapies, treatment at luxury drug rehabs, and over-the-counter medications are typically not covered.

If you are not sure whether your Humana health plan covers addiction treatment or what is or isn’t covered, feel free to call the National Drug Helpline at 1-844-289-0879 to find out more about your benefits and coverage.

Paying Out-of-Pocket Expenses for Drug Rehab

Chances are you will have to pay some of the expenses of your addiction therapy. While it may seem like a financial burden, it could be the investment that finally changes your life for the better. Think of all the money you spent using drugs or alcohol. The costs of addiction treatment tend to be much less than the costs of your drug use.

Some facilities offer sliding-scale costs or scholarships depending on your financial situation. In addition, options for payment plans may help with the costs of drug treatment. Make sure you use the resources available to help you enjoy a drug-free life.

Last updated: March 9, 2023