Humana Health Insurance

Humana Rehab Coverage

Humana is one of the largest providers of health insurance in the U.S., including group insurance, as well as a range of Medicare plans including Medicare Advantage, Medicare prescription drug plans, and Medicare supplement plans. Individual and family plans are available for health coverage, as well as dental, vision and pharmacy insurance, and there is a range of Humana plan options for employers.

Humana also offers coverage and different plan options for mental health services, which can include substance abuse treatment. While Humana recently announced it would be leaving state insurance exchanges created by the Affordable Care Act, the law does require a certain level of mental health and substance coverage, as required under guidelines outlined by the ACA.

Does Humana Have Rehab Coverage?

According to Humana, their products and coverage options provide resources and payment options for general mental health services, as well as treatment for substance abuse. The specific coverage and copay requirements may depend on the individual policy, as well as the state you live.

While Humana does cover some substance abuse services, depending on a member’s specific benefit plan, they may be required to transfer to a facility that’s part of the Humana Behavioral Health Network.

If you need to speak with a Humana representative to learn more about your substance abuse service and treatment options, you can call 1-800-777-6330, or use the Customer Service number located on the back of your member behavioral health benefit card.

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Humana Mental Health

Humana has a network of more than 65,000 psychiatrists, psychologists, social workers, licensed professional counselors and nurse practitioners. Members with Humana insurance can contact the company or visit their website to determine the mental health providers that will be in-network for them.

Is Humana Mental Health Covered By Insurance?

Humana insurance covers mental health services. Members are asked to contact the Member Service number on their Humana ID card to find mental health providers, and the insurance company informs members that some health plans may use a different network of mental health care providers. People with Humana insurance can contact a Member Service Specialist to find the right service providers for their needs. Many of the mental and behavioral health services provided by Humana are administered by Humana Behavioral Health, which is a wholly-owned subsidiary of Humana

Humana Behavioral Health

Most Humana insurance policies cover a wide variety of behavioral health services, which include substance use services. These are available for holders of both Humana commercial policies, as well as Medicare Members. Humana Behavioral Health manages these services. For Medicare Advantage Private Fee-For-Service members, and services provided by nonparticipating health providers for those people who are MA PPO members, no preauthorization is required for behavioral health service. Notification is required, but not authorization.

Is Humana Behavioral Health Covered by Insurance?

Humana covers behavioral health services for members, but many of these services do require Humana Behavioral Health provides preauthorization before coverage is given.

The following behavioral health services require preauthorization from Humana:

  • Inpatient hospitalization
  • Partial hospitalization
  • Residential treatment
  • Applied behavioral analysis
  • Electroconvulsive therapy
  • Transcranial magnetic stimulation

What To Expect From Humana for Rehab

While Humana does cover many of the costs associated with treatment for mental health disorders and substance use disorder, these services often require preauthorization. Members can use Humana Behavioral Health’s online preauthorization tool at any time, located at www.onlineauth.com. This will allow them to obtain preauthorization for intensive outpatient care, partial hospitalization, acute inpatient psychiatric care, acute inpatient detoxification, and routine outpatient services.

Members can also submit preauthorizations by phone.

There are some state-specific inpatient preauthorization forms and requirements for Texas and Indiana, which must be taken care of for the coverage of certain behavioral and rehab services.
Copays and coinsurance cost sharing may vary, depending on factors such as the plan a member has, their deductible, the facility they’re attending, and the state they live in.

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Humana was last modified: March 29th, 2017 by The Recovery Village