What is Insurance?

humana insurance coverage for addiction treatment

Insurance is a contract that transfers financial risk from a person or business to an insurance company. These financial risks can come in the form of injury, accidents, sickness, checkups, etc. 

There are many different types of insurance. The government determines these types of insurance based on the risks that they are covering. For example, insurance that covers any financial risk that deals with your health is called health insurance. On the other hand, insurance that covers any financial risk that deals with your car is called car insurance. Health insurance covers the cost of addiction treatment financial risks. 

In-Network vs. Out-of-Network Insurance Healthcare Providers

In-network healthcare providers are businesses that have contracts with your insurance company. These contracts allow the company to provide its members with discounted rates to the services of that healthcare provider. These contracts also benefit the provider by allowing it to be on the referral list of any doctor who is treating a patient with said provider. Thus, the insurance company gets to save money while the healthcare provider gets more business. It’s a win-win.

Out-of-network healthcare providers do not have a contract with your insurance company. Therefore, when you receive a service from a healthcare provider that doesn’t accept your insurance, you are paying full price rather than a discounted price. Many insurance companies only offer its benefits to patients of companies that are within their network. 

What is Humana Insurance?

Humana Insurance is a health insurance company. Created in Kentucky in the 1960s, Humana first started out as a nursing home company. In fact, at the time that Humana was a nursing home company, Humana wasn’t even the company’s name. After becoming the largest nursing home company in the nation at that time, Humana started focusing on becoming a hospital operator. 

It was while operating as a hospital operator that the company changed its name to Humana and started creating its own health insurance plans. Healthcare plans become such a success with Humana that the company eventually decided to just focus on creating and managing healthcare plans. Once this decision was made, the rest is history. Humana is now one of the largest health insurance companies in the U.S.

What is Addiction Treatment?

Addiction treatment is a rehab program for people who suffer from alcohol and drug misuse. People also use addiction treatment to help treat their mental disorders. 

There are several different forms of addiction treatment programs. The format of addiction treatment you choose will depend on the intensity of your addiction and your personal needs.

Inpatient Addiction Treatment

Inpatient addiction treatment is a rehab program in which the people suffering from addiction live in a treatment facility 24 hours a day. The length of time that a person receives inpatient treatment varies on the severity of their addiction. It also depends on the type of inpatient rehab program they are in. 

Residential inpatient treatment is a casual community-like rehab program that requires its patients to stay at their treatment facilities. This can be for a period of up to six months. Other people in inpatient treatment go to regular inpatient rehab. Regular inpatient rehab is a rehab program with some hospitalization services and restrictive 24/7 monitoring. 

While regular inpatient treatment is more intense than residential inpatient rehab, it is shorter in time. This is because regular inpatient rehab programs tend to only go for a few weeks. 

When it comes to inpatient treatment programs, the level of health insurance coverage that you’ll receive depends on where you live, the type of Humana health plan you choose, and your treatment facility. Sometimes a health maintenance organization (HMO) will only cover treatment services whose treatment centers have a contract with the HMO and an agreement with Humana. 

If the treatment facility you choose is within Humana’s network, it does not need to be local to receive coverage. Take note, though, that Humana will require you to pay your copay and perhaps your deductible out-of-pocket. You should also know that Humana requires the doctors of addiction treatment patients to refer them to a facility prior to Humana paying for any sort of treatment. 

Outpatient Addiction Treatment

Outpatient addiction treatment is a rehab program that only requires its patients to go to a facility for treatment during the day. At night, people in outpatient treatment get to spend their time in the comfort of their own homes. 

Similar to when dealing with inpatient addiction treatment, the amount of coverage your Humana insurance will provide you will depend on where you live, the health insurance plan you choose, and the treatment facility. Humana will only cover your outpatient treatment program if it is at a facility within the network. 

Overall, Humana insurance for outpatient addiction treatment is less than that of inpatient addiction treatment. Still, though, you will have to pay the copay and deductible out-of-pocket when using Humana insurance for outpatient treatment. 

Detox

Detox programs are rehab programs that focus on cleansing their bodies of all alcohol and substances. To do this, the patients must stop taking the substances that they are addicted to and withstand any withdrawal symptoms they may experience as a result. 

Some detox programs allow their patients to take medication to help them cope with their withdrawal symptoms. Humana insurance covers a variety of inpatient and outpatient detox programs. Your level of Humana detox coverage depends on where you live, the health plan you choose, and the treatment facility. 

Mental Health

Mental health is a person’s emotional, psychological, and social well-being. Examples of mental health disorders include depression, anxiety, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). When a person has a mental disorder, he or she should seek out mental health treatment. Like all treatment programs, this costs money. Luckily, Humana does provide coverage for mental health treatment. 

According to Humana’s Preferred Provider Organization (PPO) Plans, you must first pay the deductible and copay for your treatment services before receiving your health benefits. When it comes to inpatient mental health services, Humana will cover 80% of the costs as long as the treatment facility is within Humana’s network. When it comes to out-of-network inpatient mental health treatment services, Humana will pay for 50% of the costs. 

For outpatient mental health treatment services, Humana only requires its members to make a $30 copay when meeting with therapists. Humana will then cover the rest of the cost.

Dual Diagnosis Treatment

Someone with a dual diagnosis has both a substance use disorder and a mental health disorder. Dual diagnosis treatment gained traction after medical professionals began to notice that many people who suffer from addiction also have a mental disorder. There are both inpatient and outpatient dual diagnosis rehab centers.

If you can prove your doctor diagnosed you with both an addiction and a mental illness, your insurance should cover some of the costs. Ultimately, though, the level of coverage that your Humana insurance will have for your dual diagnosis treatment will depend on the insurance plan that you choose. 

Some dual diagnosis rehab centers will make you pay for all your treatment services upfront. Then your insurance provider will reimburse you later. Most dual diagnosis treatment centers will work with your insurance though. 

Co-Occurring Disorder Treatment

Co-occurring disorders are disorders in which there are illnesses that contribute to or come as a result of an addiction. Dual diagnosis disorders differ from co-occurring disorders. Dual diagnosis disorders always include some combination of a mental or physical disorder. For example, a dual diagnosis disorder could include depression and alcoholism. 

Co-occurring disorders, on the other hand, are ones in which a variety of different types of diseases can be included with a substance use disorder. Essentially, as long as one of the two disorders within a co-occurring disorder is a substance use disorder, the other disorder can theoretically be anything. There are variations in the types of disorders included in dual diagnosis and co-occurring disorders. Most people use both of these terms to refer to someone that suffers from a mental illness and addiction. 

When treating a dual diagnosis disorder, the level of coverage that Humana insurance will provide depends on your insurance plan. You should be able to receive a good amount of coverage for your co-occurring disorder treatment, though. 

Therapy

When it comes to outpatient counseling with a therapist, as long as you pay your copay, Humana health insurance will take care of the rest. Inpatient counseling will cost you more if it is out-of-network than if it is in-network.

Alcohol and Drug Rehab

For Humana to cover a large portion of the cost of your alcohol and/or drug rehab, the rehab must be specified as covered and be medically necessary. Other things that factor into whether or not Humana will cover a large portion of the cost of your rehab include the plan that you choose, where you live, any legal requirements, and the type of drug and/or alcohol addiction that you are going to rehab for. 

If for some reason your Humana plan does not have substance abuse treatment coverage, you can purchase a separate substance abuse treatment plan. Humana provides its members with the opportunity to purchase a separate substance abuse treatment plan because it is required by law to provide its members with some sort of alcohol and substance abuse treatment coverage. 

Most Humana plans offer substance abuse treatment coverage for inpatient detox, outpatient detox, inpatient rehab, outpatient rehab, and treatment for addiction to prescription medications. 

Come Receive Treatment With Us

At Harmony Ridge Recovery Center, we provide the best treatment possible for all of our members. With detox and treatment programs that treat addictions to substances ranging from alcohol to benzodiazepines, we’ve got you covered.
To learn more about Humana insurance and its benefits, you can contact us at any time.