Humana Rehab: Does Humana Health Insurance Cover Rehab?


At least 21 million Americans struggle with drug addiction. Yet comparatively few of these individuals seek treatment. In fact, only 10% of those battling addiction get the help they need. 

The obstacles to treatment are many. With the right information and resources, though, they are surmountable. In some cases, they aren’t even obstacles at all.

For example, many people worry about whether they’ll be able to afford treatment. Fortunately, health insurance often covers addiction treatment. Humana is among the major insurers offering rehabilitation coverage.

Find out more about Humana rehab in this helpful guide.

What Is Humana Health Insurance?

Humana health insurance covers more than 20 million Americans. This number makes it one of the largest health insurance providers in the United States.

Humana health insurance plans offer a variety of options. These include individual medical, pharmacy, vision, and dental plans. They also include group coverage through employers.

Humana even provides coverage through Medicare and Medicaid plans in several states. Finally, Humana Military offers coverage to service members and their families.

Does Humana Cover Rehabilitation?

Under the Affordable Care Act, all health insurance plans must include some coverage for mental and behavioral health. Thus, all Humana plans offer at least some drug and alcohol addiction treatment coverage. 

Humana has dedicated an entire subsidiary to mental health and addiction treatment. 

Humana Behavioral Health offers:

  • Access to participating addiction treatment facilities and providers
  • Help coordinating addiction treatment
  • Case management when treatment requires recurring hospitalization or other ongoing and complex care
  • 24/7 access to its customer support team for questions and concerns

Humana Behavioral Health promises to advocate for clients throughout the addiction treatment journey. Finally, they maintain complete confidentiality at all points of that journey.

What Addiction Rehabilitation Services Does Humana Cover?

The type and amount of coverage for rehabilitation varies between plans. Your place of residence and various legal requirements can also affect coverage.

In general, though, Humana rehab options include:

  • Inpatient and outpatient detox, or withdrawal management
  • Inpatient and outpatient rehab
  • Prescription medications

When determining coverage, Humana considers whether treatment is medically necessary. Treatments deemed necessary are typically covered. A doctor’s referral is required to establish medical necessity and secure coverage. 

In determining coverage, Humana also considers whether a service contributes to addiction recovery

The following are not covered by Humana plans:

  • Over-the-counter medications
  • Luxury facilities
  • Executive treatment
  • New Age treatments

Other treatments that lack empirical evidence also may not be covered. Services like housekeeping at inpatient facilities may qualify only for limited coverage. Likewise, supplementary activities, like music and art therapy, may involve limited coverage.

How Much Coverage Does Humana Rehab Typically Offer?

The coverage you can expect from Humana varies based on your plan and the other factors above. In most cases, though, you will be responsible for copays for covered treatment. A copay is a set fee that you, as the policyholder, pay a provider at the time of service.

You will also need to meet your deductible before Humana rehab coverage kicks in. A deductible is a set amount that you must pay each year before your insurance begins paying. Typically, copays do not count toward your deductible.

Coinsurance rates are another factor to consider. After meeting your deductible, you may remain responsible for part of the bill. Your coinsurance rate determines the amount for which you are responsible.

Outpatient treatment is usually less expensive than inpatient treatment. Thus, copays for outpatient treatment will generally be lower. Outpatient treatment will also not impact your deductible as much.

Does a Drug Addiction Treatment Provider Need to Be In-Network?

Working with an in-network provider is usually the easiest and least expensive option. In most cases, Humana plans won’t cover out-of-network providers. This leaves patients covering the full cost of treatment themselves. 

In some cases, Humana will cover out-of-network treatment centers. Still, the plan holder will typically pay higher copays and deductibles.

Importantly, though, a distinction should be drawn between Humana HMOs and PPOs. PPOs are preferred provider organizations; HMOs are health maintenance organizations.

Of the two, PPOs are typically more flexible. Humana PPOs may cover care from in- and out-of-network facilities. At the same time, they may have higher premiums, deductibles, and coinsurance rates.

In contrast, HMOs are more restrictive about where you can seek treatment. Yet, they may have lower coinsurance rates and lower deductibles. 

Does a Drug Addiction Treatment Provider Need to Be Local?

With Humana health insurance, geography does not limit your choice of providers. You are free to explore treatment facilities in your local area or elsewhere.

How Can I Get Started with Humana Rehab Treatment Coverage?

The first step toward rehabilitation is usually a visit to your primary care doctor. He or she can provide you with a referral for drug addiction treatment. This referral is necessary if you intend to use Humana to cover your treatment.

You may also need to seek preauthorization to ensure coverage. This is especially true if you need inpatient services. Failure to do so can result in costly penalties.

As you begin your journey toward recovery, it’s important to learn as much as you can about your options. So take your time and find the best rehabilitation facility for your needs.

It’s also important to learn as much as you can about your insurance plan. Humana customer service representatives can help you understand your plan and its benefits. 

Your chosen facility’s intake personnel offer another invaluable resource. They are extremely knowledgeable about treatment options and insurance coverage.

Finding a Covered Path to Addiction Recovery with Humana

Navigating the road to recovery can be a frightening and overwhelming journey. Despite the challenges, though, this journey is worth it—because you are worth it.

You are worth the work necessary to live your best life, and you are capable of completing that work. You are capable of navigating the road to recovery.

When you’re ready to take the first step, Humana rehab can help, and so can we. Southern Californian Sunrise Recovery Centers will walk beside you each step of the way.

Contact us for a free insurance verification or other information today.

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