NOTICE: Step One Rehab works hard to make sure our information is accurate. Due to constant changes in insurance company policies, we suggest you contact your insurance company with your member ID for any policy questions. This FAQ is only intended as a guide to point you in the right direction.
Humana Drug and Alcohol Rehab Coverage – FAQ
Where does Humana Operate?
Humana operates in over 20 states. It is one of the largest insurance providers in the US.
Does Humana Cover Rehab?
Yes, Humana usually will cover drug rehab. They base coverage on a number of factors which vary based on your plan. Humana offers a host of individual medical plans for health insurance. They have HMO and PPO plans.
Humana will most often provide partial coverage. You are responsible for whatever they do not cover. Nearly all their plans have a deductible. You have to pay your deductible amount first before your insurance coverage takes over.
Most Humana plans have coverage for the following:
- Inpatient/residential treatment
- Partial hospitalization
- Intensive outpatient programs (IOP)
- After-care programs
- Various mental health and behavioral health programs
- Humana does not cover:
- Over the counter medication
- Non-medically recognized therapies (yoga, etc)
- Private Rehab Facilities
To manage your Humana health plan, or learn more about it, you can visit Humana’s Website. They also have a mobile app.
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How Long will Humana Cover Addiction Treatment?
Humana coverage length varies. It can range from as few as 3 days to several months. They base their coverage on a number of factors.
Out-of-Network providers are allowed with their PPO plans. They are not allowed with an HMO plan, or will incur additional costs.
Contact Humana to confirm your level of coverage, if any, for out-of-network providers.
Does Humana Allow for Treatment at Luxury Rehab Facilities?
Not usually. They may allow it if you have a PPO plan. For reference, Luxury (or private) drug rehabs are often where wealthy people and celebrities will go for addiction help. They are often as nice as any hotel or resort you may use for a vacation spot. They usually have massages, acupuncture, hot-tubs, pools, and quality dining, in addition to other exclusive privileges.
Inpatient Addiction Treatment vs. Outpatient Treatment
This is one of the biggest and most important choices that a patient or their family will make when looking for addiction help. Where you go, and what you do from here on matters and can determine your level of success.
Both options are better than not seeking treatment and could save your life. They each have their own strengths and weaknesses.
An outpatient facility is usually a local option. They give you the chance to meet with medical professionals like doctors, alcohol and drug counselors, or therapists, attend group sessions, and go to recovery meetings while being able to head home afterwards. Co-pays may be required for each visit.
Inpatient facilities, also called residential programs, are most often 28 day programs. They provide structure and are typically remote destinations where you stay in the facility for the duration of the program.
Do I need Insurance to go to Rehab?
You are not required to have insurance to get addiction treatment. However, without insurance, the cost of drug rehab facilities is usually very expensive and impractical for most people. You would need to pay out of pocket. You can certainly pay with a credit or debit card, work out a payment plan, or use other methods that each facility accepts.
Typical inpatient rehabs may cost anywhere from $6,000-$20,000 for a 28 day program.
Outpatient Rehab can range from $4,000-$10,000 for 90 days. The cost of outpatient rehab will vary and is mostly based on how many visits are made.
How does Humana Decide my Claim?
Humana makes decisions about their coverage based on your health plan. They comply with all Federal guidelines. Each claim decision is reviewed on a case by case basis and varies by state. In general, Humana will look at services you use. They then follow national guidelines and other policies to determine if your claim is covered. Services that may be covered can include drug addiction rehab, blood-tests, surgeries, or hospital stays.
For drug treatment, you will need a doctor’s evaluation and recommendation. Your claim is then decided based on medical necessity: if Humana does not consider treatment to be needed, they won’t pay for it.
If they will not pay, your claim is denied. Humana will send you a notice. You DO have the right to appeal. To start an appeal with Humana, call their Member Services number on your Humana ID card. They typically allow 60 days from the date of the initial payment or denial notice to file, but this deadline can vary, so check any documentation they send. If Member Services doesn’t resolve your issue, ask for an appeal.
Follow this link to see more about Humana’s Appeal Process.
Humana appeal forms can be found HERE. It is possible to get appeals expedited.
What Else does Humana Provide?
Humana has a host of health and wellness options and discounts
They serve more than 33 million Americans.
A variety of plans you can customize and the ability to manage and adjust your plan.
Anything that you say is kept confidential, so you don’t have to worry about everyone knowing you may have trouble with alcohol or drugs.
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Get an Approved Humana Drug and Alcohol Rehab
Verifying what insurance will cover can be a time-consuming process. This hassle usually involves lots of waiting and multi phone calls back and forth. Our knowledgeable staff can verify your coverage for you and take the stress and annoyance out of this already difficult time. You have enough to worry about already. Verifying insurance coverage for rehab shouldn’t be an additional burden.
Instead, give us a call now and let us handle this step, at no cost to you! We are totally confidential. Our number is 877-348-7494