Humana health insurance is one of the major insurance firms in the United States, serving 16 million individuals with healthcare coverage. Humana health plans include a prescription medication plan, as well as vision and dental care, as well as employer-provided group insurance.
Humana provides a variety of Medicare coverage options to more than 8 million Medicare users throughout all 50 states. Humana Behavioral Health provides a comprehensive range of inpatient and outpatient drug and alcohol rehabilitation treatments. The exact type and number of services provided will differ depending on the package.
Individual medical insurance plans come in a variety of forms, the most prevalent of which are likely preferred provider organizations (PPOs) and health maintenance organizations (HMOs) (HMOs). A Humana PPO may be more flexible than an HMO, enabling consumers to seek treatment both in-network and out-of-network without a referral. An HMO requires you to choose a primary care physician (PCP) and only see in-network doctors. Coverage and plans may change depending on where a person resides, and they may differ across states.
Humana Military, a division of Humana Inc., also provides coverage to military service personnel and their families.
Should the Centers Be In-Network?
Humana insurance does not often cover out-of-network treatment centers. This means that plan members will have to bear their own expenses. In the rare case that an out-of-network facility is covered, the treatment seeker will often be required to pay higher deductibles and copays. Humana also needs patients to have a doctor’s reference before they fund the treatment. Humana will not additionally cover the following:
- Over-the-counter medication
- Luxury and private facilities
- New Age therapies
- Executive treatment
Substance Abuse Coverage
Humana covers a wide range of addiction treatment and rehab services, depending on specific plan details, where the client seeking treatment resides, legal requirements, and the type of therapy requested. Humana also provides consumers with the option of purchasing a supplemental drug addiction coverage plan if their plan does not contain it. Humana states that “in order to be reimbursed, costs must be medically essential and specifically stated as covered.” Humana plans generally cover the following treatment options:
- Inpatient detox
- Inpatient rehab
- Outpatient detox
- Outpatient rehab
- Prescription medications
Inpatient Treatment Coverage
The decision to cover inpatient treatment, as well as the amount covered, is totally based on the particular plan and criteria, such as the state in which the treatment seeker resides. In most situations, the facility must be in-network in order to be covered. It also cannot be a high-end or exclusive facility. Because Humana requires patients to be referred to a treatment center before they would pay, it is essential that patients discuss their treatment choices with their doctor before deciding on a course of action.
Although Humana only covers in-network facilities, it does not discriminate based on location, so patients are not required to stay close to home to be covered. Most Humana plans will require policyholders to pay copays for numerous services. A copay is a set amount that the policyholder must pay before Humana covers anything. Most plans also require policyholders to meet their deductible, which is a predetermined amount of money that a patient must pay over a certain period of time (typically a year) before Humana would pay for anything.
Outpatient Treatment Coverage
Humana’s outpatient treatment coverage is substantially comparable to its inpatient treatment coverage. The type and quantity of coverage will be determined by the particular plan as well as a number of other criteria. In general, outpatient therapy is less expensive than inpatient treatment and may not have the same impact on deductibles. Most Humana plans include prescription drug coverage, which covers at least a portion of the cost of outpatient addiction treatment medicines.
Most Humana plans, like inpatient therapy, require policyholders to pay copays and meet deductibles before Humana would pay for outpatient treatment expenditures.