The River Source believes that addicts who want to receive treatment for their substance abuse problem should have as few barriers as possible. To support this, we accept most major insurance plans and work closely with patients and their families to reduce or eliminate out-of-pocket charges.
I Have Humana Insurance. Can I Get Treatment in Arizona?
If you have Humana Health Insurance, you may be wondering what substance abuse treatment options are available to you or a loved one. Fortunately, Humana is one of the largest providers of health coverage in the United States. Resources and payment options for substance abuse and mental health services are included with each plan.
Being one of the largest insurance providers in the U.S., The River Source has extensive experience working with Humana. While each plan is unique, we can answer most of your questions and help you better understand your copay requirements, specific coverage and out-of-pocket expenses.
We’d like to take the time to answer some of the questions we hear most often from our patients and their families. If you have additional questions or concerns, don’t hesitate to reach out! All calls are friendly and confidential.
Does Humana Cover Drug Rehab Costs in Arizona?
The most important question that people have is whether treatment for a drug or alcohol addiction is covered under Humana. The good news: Yes. Humana’s products do include some type of treatment coverage. How much is covered is the issue.
To better understand why treatment costs vary, let’s briefly review the differences between PPO and HMO insurance plans, both of which are offered by Humana.
- Humana HMO Plans
An HMO plan allows access to in-network physicians, hospitals and treatment facilities only. These providers have agreed to lower rates for its members, and coverage is only guaranteed if you see a health professional in this network. Referrals are also necessary when seeing specialists.
- Humana PPO Plans
A PPO healthcare plan is more flexible because you can choose any physician or treatment specialist. PPO plans are even willing to pay for non-network doctors, though the costs may be higher. Also, you don’t need a referral to see a specialist. However, PPOs tend to have higher premiums and copays.
Speaking of copays, most insurance plans have them. For example, if you have an 80/20 plan, this means that the insurance company is responsible for 80 percent and you are responsible for 20 percent. Also, depending on your specific plan, it’s possible that treatment is only covered up to a certain limit. If you go over this limit, the rest will need to be paid out of pocket.
What Insurance Plans Does Humana Offer?
Now that you have a basic understanding for how insurance works, let’s look more closely at what Humana insurance coverage provides.
Humana has several plans that are accepted in Arizona. They include:
- Portrait plan. This plan offers benefits that are similar to what big employers provide. It’s best for those who are self-employed, newly retired or working for a company that does not provide group health insurance. This plan is an 80/20 with in-network deductibles ranging from $1,000-$2,500 for singles and $2,000-$5,000 for families.
- Monogram plan. This is another one of Humana’s main plans. It’s ideal for people who want low-cost protection. Because of this, it’s best suited for those who are relatively healthy and don’t visit the doctor often. Though the plans are affordable, they do have higher deductibles and higher copays, reaching up to $7,500 for a single and $15,00 for a family.
- Autograph plan. The Autograph Plan is built to the individual needs of the person. Individuals who have certain illnesses or injuries and require personalized treatment benefit most from this plan.
- Medicare plans. Humana offers Medicare plans that provide Medicare coverage and participate with Medicare. Many products are available, including Gold Choice PFFS, Gold Plus HMO and Choice PPO.
What Addiction Treatment Services are Covered by Humana?
Humana insurance plans do provide coverage for substance abuse treatment. The types of services provided are:
- Withdrawal management. Humana will cover at least part of the cost of a residential detox program. Patients must fit the definition for medical necessity. It’s usually required that treatment providers submit detailed treatment plans, dates of admission and discharge, progress updates and more. If you or a loved one does not fit the definition of medical necessity, an outpatient detox program can be chosen instead.
- Outpatient treatment. Humana will cover at least part of the cost of outpatient treatment depending on the plan. Most therapies and treatments administered need to be deemed medically necessary to be covered. Evidence-based treatments are always more likely to be covered than experimental ones.
- Humana will generally cover the cost of medications as long as they are being used responsibly. Again, medications that lack scientific evidence are less likely to be covered.
Does the Arizona Treatment Center I Choose Make a Difference?
Sometimes, people rush into choosing the first drug rehab that accepts their policy. Unfortunately, this could also mean that you or a loved one receives less care and more out-of-pocket expenses. If your Humana policy could cover up to 28 days in a licensed treatment facility, wouldn’t you want to know?
The River Source takes pride in offering cutting-edge, integrative care. All of our treatments are backed by scientific evidence. This means that more of our services are likely to be covered. Additionally, our treatment center is not a luxury facility. While our centers are impeccable, we minimize distraction and keep our prices affordable. If your insurance caps you at a certain limit, you will end up receiving more care from our qualified team of doctors, nurses and counselors compared to other facilities.
To ensure that you receive the maximum benefits from your insurance plan, take the time to understand your policy and benefits. Knowledge is power. Call The River Source to speak with one of our Humana Rehab Specialists and let’s answer your questions.