What Is Humana?
With more than 20 million members, Humana is one of the top 10 biggest healthcare providers in the United States.1 From its inception in 1961, Humana has risen to the challenges put before them to bring quality healthcare to Americans.2 Humana serves Medicare beneficiaries in all 50 states, making them a top provider for recipients.3
For those struggling with alcoholism, understanding Humana’s coverage for substance abuse treatment is a crucial step for those seeking recovery from addiction.
Humana Health Insurance Plans and Coverage Levels
Humana is a Medicare Advantage HMO, PPO, and PFFS organization.4 It also serves as a stand-alone prescription drug plan contracting with Medicare.4 Humana’s HMO, PPO, and PFFS are defined below:5
- Health Maintenance Organization (HMO): In an HMO, you must stay within a given network of providers to be covered by insurance. Your primary care doctor will help you manage services by providing referrals to specialists that are within the network. This plan usually has a lower out-of-pocket cost.
- Preferred Provider Organization (PPO): This type of plan offers a larger network of doctors and specialists from which to choose. You can go in- or out-of-network without a referral for services. This plan may have higher deductible costs.
- Private Fee-For-Service (PFFS):6 A Medicare PFFS plan is a type of Medicare Advantage plan (Part C) provided by a private insurance company. This type of plan determines how much payment goes to the doctors, healthcare providers, and hospitals and what your out-of-pocket costs will be.
If you’ve served or are serving in the military, Humana Military may be an ideal insurance plan for you.7 This plan covers military service members and their families. It is in partnership with the Department of Defense and administers TRICARE health programs.7
Humana also has a special needs insurance plan, which is Humana SNP. This plan works with a large network of providers and is similar to an HMO. You will have a primary care doctor to help you manage your care.8
Does Humana Cover Alcohol Rehab?
Yes, Humana covers alcohol rehab under the behavioral health component of the insurance.9 There is no one-size-fits-all solution to addiction treatment. Some may need more intensive, inpatient care, while others may benefit from outpatient settings. The type and length of alcohol rehab needed may be determined by your primary care physician or addiction treatment team.
Types of Humana Alcohol Rehab
Humana’s alcohol and substance abuse treatment services may include the following:
- Medication-assisted treatment (MAT).
- Counseling and therapy, such as cognitive-behavioral therapy (CBT).
- Inpatient treatment.
- Outpatient treatment.
As with any healthcare provider, check your plan’s exact specifics to find out what is covered.
Does Humana Cover Inpatient and Outpatient Alcohol Rehab?
With the passing of the Affordable Care Act (ACA), coverage for addiction treatment is now required for all providers.10 While both inpatient and outpatient services may be covered by Humana, you’ll want to speak with your provider to learn about the specifics.
Regardless of setting, treatment is more likely to be covered when seeking care at an approved facility or program. Often, insurance companies approve programs that have been through a review process and are determined effective and eligible. Rehab programs that offer evidence-based treatments are more likely to be approved, so be sure to check with your insurance provider or the rehab facility directly whether you will be covered.
The amount covered can vary depending on the type of plan you have, so you may still have some out-of-pocket costs.
How to Check My Humana Coverage for Alcohol Rehab
The easiest and fastest way to put your mind at ease about whether Humana covers substance abuse treatment is to speak with your provider or call a treatment facility directly. Alcohol.org is a subsidiary of American Addiction Centers (AAC), a nationwide provider of treatment facilities.
AAC offers evidence-based care for those struggling with addiction and offers customized plans for patients in order to better serve each person’s unique needs. If you’d like to speak with an admissions navigator today about your treatment options or to verify if your insurance covers treatment with AAC, call us today at 1-888-685-5770 .
Our admissions navigators are available 24/7 and all calls are 100% confidential. There’s no obligation to make any decisions right away, we’re here to help you understand what steps you can take toward recovery and sobriety.
- Vault. (2021). Humana Insurance Company.
- Companies Histories.com. (2021). Humana, Inc. history, profile and corporate video.
- Humana. (2020). Humana Rolls out 2021 Medicare Advantage Health Plans with Expanded $0 Premiums and Enhanced Benefits in More Counties Nationwide.
- Humana. (2021). Member guidance.
- Humana. (2019). HMO vs. PPO: Which one is right for you?
- Humana. (2020). Humana private-fee-for-service (PFFS) plans.
- Humana. (2021). Humana Military.
- Humana. (2021). Humana Medicare Advantage Plans.
- Humana Behavioral Health. (2015). Our Behavioral Health Products.
- Healthcare.gov. (n.d.). Mental health & substance abuse coverage