As the largest health insurance provider in the United States, Humana Health offers both individual and Medicare insurance plans. And in recognition of the intense and growing need for addiction treatment throughout the United States, Humana offers several options for members who may be struggling with substance abuse or addiction. Humana also has a subsidiary, Humana Behavioral Health, to address all things related to health insurance regarding behavioral health for Humana members. Additionally, the insurer offers confidential telephone assistance twenty-four hours a day, seven days a week, for members who have questions about their benefits for issues like anxiety, depression, bipolar disorder, and substance abuse.
Some of the additional behavioral health services offered by Humana include:
Humana also provides an optional case management program for members who have frequent and chronic behavioral health needs. This program provides a behavioral health clinician who remains on hand to ensure that the members’ needs are being met, and that their healthcare and wellbeing are as optimized as possible. The case management program does several things for members, from assisting them to apply their insurance benefits to an addiction treatment program to reintegrating them back into their communities. This process may consist of:
Additionally, Humana uses the American Society of Addiction Medicine (ASAM) criteria for Illinois Chemical Dependency, available online to treatment providers, for guidance.
Like many health insurance providers, Humana Behavioral Health Services also requires pre-authorization for certain addiction treatment services. With exemptions for Medicare Advantage, private fee-for-service, and nonparticipating providers using a Humana PPO plan.
The list of required pre-authorization services includes:
The time it takes for a decision on medical necessity when a pre-authorization is submitted for addiction treatment may vary depending on individual circumstance, which may delay the application of benefits. It is advised to obtain pre-authorizations for any inpatient addiction treatment service as far as possible in advance of your admission date. If this cannot be done due to an emergency requiring immediate admission to a facility, Humana can work with you to expedite the process of determining medical necessity. Just as all other insurance providers, Humana tries to make their policies and coverage as clear and understandable as possible, but also acknowledges that the language and terms can be confusing when it comes to specific services and treatments.
Much more complicated than a checkup with your primary care physician, addiction treatment may be comprised of several elements, and your Humana insurance plan may cover the entire cost no matter what treatments are included. Alternatively, some treatments that Humana may not deem medically necessary could be billed separately and remain unpaid by your insurance benefits. Typically, therapies like individual and group counseling and other evidence-based therapies are likely to be covered by your Humana plan. However, therapies like animal-assisted therapy (i.e. equine-assisted), art and music therapy or yoga may not be considered necessary and may become your financial burden.
It is important to understand details like these about your Humana health insurance plan and benefits. Once you have an understanding of how Humana handles these types of therapies and any other accommodations offered, it is necessary to check with your preferred treatment program regarding how they bill insurance for the various treatments provided. Any addiction treatment program will be able to verify the specific details of your Humana insurance plan and benefits. At that time, it is recommended to verify how billing is handled by the treatment program.
For assistance with understanding how your Humana insurance plan works and what it covers, AllTreatment.com is here to make sense of it. We’re available to check and verify your benefits and discuss with you how they apply to various kinds of addiction treatment. We can also work with you to help you narrow down the programs most effective for your recovery, and for your wallet.
We understand there is nothing simple about addiction, health insurance, or recovery from addiction, and that is why we work hard to provide the most accurate and updated information to simplify these processes as much as possible.
When in the throes of addiction, you or a loved one don’t need the bureaucracies and confusion of health insurance terms—just a simple explanation of your full benefits and how they can be used to get you the most effective addiction treatment available.
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