humana

Humana Health Insurance for Addiction Treatment at Coastal Detox

Figuring out health insurance has always been a difficult task. The majority of people know that they have some sort of health coverage, but do not know what their plan is and what type of care it covers. Humana is a health insurance carrier that provides coverage for not just the health aspect, but also recognizes the importance of wellbeing as a part of overall health. Dealing with drug and alcohol addiction and needing treatment is difficult enough. Humana offers quite a few different policies and services that provide coverage for an array of care needs. On this page, we will break down the opportunities for specialized care and which plans to cover your specialized addiction treatment requirements. 

Variety in Humana’s Policies

The majority of people with Humana health coverage have drug and alcohol addiction treatment included within their plan. Humana serves over 13 million customers and is one of the topmost opted for health insurance plans available. It comes recommended by drug and alcohol treatment resource centers and is regarded among the top of the list. Based on your specific plan, the type and amount of treatment available for coverage can vary. We are here to make this as easy as possible to understand, placing you one step closer to rehabilitation through drug and alcohol treatment centers. 

Addiction Treatment and Mental Health Wellness Deserves Coverage According to Humana

Making the decision to receive drug and alcohol rehabilitation treatment is the first step. The second step is figuring out how to cover the expenses of specialized programs offered by the rehab facility, and how much is covered by insurance. Humana Behavioral Health is a portion of coverage offered by  Humana medical insurance company. As a subsidiary of Humana, Humana Behavioral Health makes it a point to include an overall mind-and-body stance on a person’s health and wellbeing. Including holistic treatment, they consider addiction treatment as a very important factor of overall health, and therefore, important to health coverage in general. 

Humana Behavioral Health has Professional Treatment Options for You

Receiving the best possible care at the time you need it most is the ultimate goal to recovery. It’s also an important understanding of the Humana Behavioral Health department’s policymakers. Making mental health and addiction treatment as available as possible, Humana offers more than 65,000 licensed care professionals to make it possible for them to offer care to the most customers as possible and as efficiently as possible. Types of medical professionals provided to you include:

  • psychiatrists
  • psychologists
  • nurse practitioners
  • social workers 
  • licensed professional counselors

Being connected to the most helpful accredited addiction treatment specialist is key to a successful and fulfilling life of recovery. Drug and alcohol resource centers understand the peace of mind provided when assisting you with treatment options that fit into your health coverage policies. 

How Humana is Available to Provide for You Today

Humana Behavioral Health takes pride in being able to assist you on your journey to health and wellness through drug and alcohol treatment resources. To do this, Humana does its best to provide you with answers to your questions and concerns by making available the following: 

  • Coordination of specialized and recommended treatment
  • Access to programs of participating providers 
  • Will advocate on behalf of patients when dealing with providers regulations
  • The management of cases where more than one hospitalization is required
  • Addressing the terms of service for behavioral health needs that often require ongoing care 
  • Make available help and service, 24 hours a day/ 7 days a week
  • Respect the confidentiality of patients as to serve the state and federal law requirements 

For any additional drug or alcohol treatment concerns, please visit the Humana Behavioral Health section of your Humana insurance policy. 

Humana Policy Coverage for Help with Substance Abuse

There are a variety of things to consider when determining what treatment and rehab services for drug and alcohol addiction are covered by Humana. A few of the top-rated factors taken into consideration when looking at you Humana Health coverage include:

  • Complex case management. This is where the needs of the individual require more than just the traditional amount of specialized care that is provided. For example, in the case of multiple hospitalizations, or the extended length of care. 
  • Individual plan details that are available for a substitution or fall under other requirements health care needs within the policy. 
  • Taking into consideration where an individual is seeking drug and alcohol treatment resources, in perspective to where they predominantly live or reside.
  • A patient’s legal requirements or court ordered obligations.
  • Whether or not there is a specific type of treatment that is being sought out or has been recommended. 

Please make it a point to discuss recommended treatment options with drug and alcohol treatment centers in order to acquire the information on the most beneficial plan available to you. 

Treatment Options Typically Covered by Default

Most health insurance policies include some sort of coverage built into every plan. In the event that a program recommended as part of your recovery treatment, add on services are available to purchase in addition to your deductible. Before we get into that, let’s take a look at which options are typically included in the average insurance policy being used by members. We usually notice that the services below are part of the most commonly purchased Humana policy plans: 

  • Inpatient detox
  • Inpatient rehab
  • Prescription medications
  • Outpatient detox
  • Outpatient rehab

Please note, as directly stated by Humana: “In order to be covered, expenses must be medically necessary and specified as covered.”

In-Network vs. Out of network with Humana Health Coverage

Some of the plans provided by Humana for drug and alcohol rehab treatment do not provide coverage or mental health facilities that are out-of-network. Meaning, there is a certain radius of coverage based on the current residing location. Usually, the terms for the network that is covered is based on the location that the policy was purchased in, due to different price ranges in different areas of medical facilities, and what they charge per service.  However, Humana generally does not restrict its coverage by geographical locations and is subject to change.  

Getting Coverage Approved for Substance Abuse Treatment 

There are instances where Humana will approve coverage for treatment programs that are out of the range of service. Keep in mind, this is not a usual exception unless referred by your primary health care physician. Referrals for drug and alcohol rehab treatment are mandatory. Because of the rarity of circumstances, doctors do not often find out of network services necessary, due to the availability of local rehab treatment centers. Having to request out of network care is not often a common occurrence. That said, patients are reminded that they can be held responsible for the costs of higher co-payments. Humana will at times require you to cover somewhat higher deductibles in out-of-network facilities.  Also, keep in mind that Humana could hold you responsible for the complete out of pocket cost, so please check with your carrier to create a proper plan of action. 

When to Have Alternate Coverage or Financial Preparedness with Humana

There are circumstances where Humana will grant coverage to out-of-network services, however, taking appropriate action with your doctor is important to be considered applicable. Other services that do not fall under Humana’s Health Care policies include:

  • Any recommended over-the-counter medications or herbal supplements.
  • New age, unconventional, or unapproved practice or therapy based on regulation treatment procedures.
  • Private drug and alcohol rehab treatment centers, including luxury programs.
  • Any sort of executive treatment

Remember, having a referral from your doctor is mandatory to be eligible for any kind of coverage.

Humana and Inpatient Treatment for Drug and Alcohol Addiction

It is important that patients review their policy allowances prior to organizing care. Unlike outpatient care, inpatient coverage varies greatly from plan to plan, and may not be offered at all. Additionally, whether or not inpatient care, or residential programs, will be partially or fully covered, if coverage is available at all, can be impacted by the location in which the treatment is being requested in. Overall, if applicable, inpatient services can and will only be provided within the customer’s network, and with your doctor’s referral. 

Humana Qualifications and Mandatory Fees

Humana requires that policyholders are responsible to make co-payments for services that are not fully covered. Some of these payments are predetermined fees that must be met before any kind of coverage may start. As with most insurance companies whose assistance is enlisted for drug and alcohol rehabilitation treatment, patients must meet the maximum annual out of pocket expenses, as set forth by the terms of their policy agreement. This is known as maximum out of pocket deductible, which must be reached before receiving additional assistance with treatment. 

Finally, Humana health insurance places a year minimum, that a patient must be a policyholder before the individual is able to use its benefits for rehabilitation purposes. 

Humana Aftercare Treatment Process

At Humana, it is understood that after receiving treatment from an inpatient rehabilitation facility, the need for care is not always over. Humana provides support for the month following having been discharged. 

The trained representatives at Humana will be sure to assist you with any follow-up checkups that are necessary.  After being discharged, a person’s success in recovery largely depends on understanding and following through with the rehab treatment centers suggested support. Team members at Humana will be available to assist you with community support programs, such as finding meetings for  AA or NA, and also provide you with convenient locations available to fill any necessary medications and observe the guidelines for appropriate prescription usage.

Coastal Detox is Ready to Provide the Help You Need

If you need treatment for drug or alcohol addiction, Coastal Detox is eager to help win the battle over substance abuse. We understand how valuable it is to have all the information you need for recovery. Let us assist you in getting the best affordable, effective treatment.

At Coastal Detox, providing the best care possible for our clients is our ultimate goal. Every person suffering from the holds of addiction can rest assured that we’re prepared to provide the best path to freedom. Don’t be afraid to ask for help. Coastal Detox is here for you and reminds you that you are not alone. For any and all inquiries, please call us today at (877) 406-6623 to speak with our addiction specialists. Don’t let addiction take another precious day. 

Reference:

https://www.humanabehavioralhealth.com/clients/products/complex-case-management 

Content Reviewed by Jacklyn Steward

Jacklyn StewardJacklyn is a Licensed Mental Health Counselor (LMHC) and an EMDR trained trauma therapy specialist with over 6 years of experience in the field of addiction. She has a Masters Degree in Mental Health and Substance Abuse Counseling from Nova Southeastern University.