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Humana, Inc. is one of the country’s largest health insurance providers, boasting over 16.6 million members and revenue of approximately $56.9 billion in 2018. In terms of market capitalization, it is the fifth largest in the US with $21.1 billion.

The company has a wide range of services, from Medicare to individual plans, dental plans, and more that are provided through employers. It also has a prescription drug program that offers mail prescription services and pharmacy services.

 

What are Humana’s group medical plans?

Group insurance plans are generally provided through employers. Some employers may pay part of the premium while others may deduct a portion of the amount form the employee’s paycheck. Humana’s medical plans include the following:

  • Has a higher monthly cost, but with lower deductibles, which results in fewer out-of-pocket fees and more flexibility in both in-network and out-of-network providers.
  • The company offers Open Access plans that allow individuals to seek treatment from any network.
  • Humana Classic. A pricier plan but plan holders are entitled to seek any provider without paying extra.
  • Point of Service. A plan that allows for more flexibility by allowing holders to use in-network providers for a lower cost or out-of-network ones with an added cost.
  • High Deductible Health Plan. A plan that includes pharmacy costs in the deductible amount. Coinsurance only kicks in when the maximum out-of-pocket cap is reached.
  • Coverage First. This plan covers most medical services and preventative care to up to $500.

Keep in mind that individual medical plans differ depending on the location. You can check the details of the above plans by doing a zip code search on Humana’s website.

 

What is Humana’s coverage for rehab?

Substance abuse falls under mental health services and a typical Humana HMO plan covers in-network hospitals, healthcare practitioners, and healthcare treatment facilities as long as they are not considered a halfway house or a residential treatment center.

Mental health services are often covered when they are considered medically necessary by a network provider. Emergency and urgent care provided by hospitals within the network are also covered. Out-of-network hospitals can be covered, provided, they are checked with Humana within 48 hours prior to admission.

 

What preventative services are provided?

Humana may include counseling and screening covered individuals over 18 and preventative tobacco counseling to dependents between 10 and 17 years. Stays in residential treatment centers may also be covered as long as they are deemed medically necessary.

Substance abuse that co-occurs with mental illness may open more coverage options under behavioral health services. Behavioral health services that are covered under Humana includes inpatient detox services, psychiatric care, partial hospitalization, psychological testing, and more. Again, these services must be medically necessary for them to be covered.

 

I need help with my PPO. Whom can I talk to?

We at Resurgence know that addictions can be effectively treated, as we help families to recover every single day in our facility. We offer inpatient and outpatient care for addiction and our aftercare approach ensures that you have the tools you need to maintain sobriety when formal treatment is through.

If you need help with your treatment, call us at 888-700-5053 so we can check with your PPO and determine the right treatment for you.