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Humana Health Insurance for Drug and Alcohol Rehabilitation in California



Humana health insurance in California does typically cover drug rehab and treatment for behavioral health issues. Humana is one of the largest health insurance providers in the United States. Like any other health insurance provider in California, the extent of coverage for drug rehab depends on the health insurance plan. There are many different types of health insurance plans through Humana that cover drug rehab. Preferred Provider Organization plans may be more flexible than a Health Maintenance Organization plan. For example, it may offer members care without a referral for both in-network and out-of-network service providers. Humana health insurance also covers military members and their families with Humana Military.

Residents of California can also access Medicare and Medicaid plans through Humana, and coverage may vary. The rehabilitation process is no different for someone with health insurance or without health insurance. The first step in treating drug addiction is drug detox, and this process manages withdrawal symptoms and cravings. However, detox should not be considered the only drug rehab approach because it will not provide adequate counseling and therapy. Following drug detox, the next step with treatment is attending a residential or outpatient drug rehab center. Typically, residential drug rehab is the better option, but this is different for each person. Humana health insurance plans cover inpatient and outpatient drug rehab in California. 


How Does Private Health Insurance Cover Drug Rehab in California?

Drug rehab generally starts with a visit to the primary care physician who can seek authorization to refer the individual to drug rehab. There are multiple aspects that factor into whether Humana health insurance will cover and pay for drug rehab in California. Every plan is different based on metal level, category, and insurance type. Humana health insurance uses metal ratings for some plans. The metal categories were created as part of the Affordable Care Act. The metal plans include bronze, silver, gold, and platinum. Bronze plans have lower monthly premiums but higher out-of-pocket costs. Platinum plans have the highest monthly premiums but lower out-of-pocket costs. Moreover, there are different plan types that include Humana Simplicity, Total Health, Level Funded Premium, Self-Funded, High-Deductible Health, and Copay Plans.

Humana also offers different types of insurance models like Health Maintenance Organizations and Preferred Provider Organization plans. The first step is to contact the Humana health insurance provider and determine what is covered and the payment options. It is also important to contact the drug rehab centers in California as some programs are in-network, and others are out-of-network. Drug rehab centers can provide information about how health insurance is accepted, what is paid, and what is covered. For example, some Humana Preferred Provider Organization plans and policies include coverage for out-of-network facilities. An HMO plan may not offer this benefit unless the facility establishes an arrangement with Humana before the patient is admitted to drug rehab.


What Type of Drug Rehab Does Health Insurance Cover in California?

The types of drug rehab facilities in California that Humana health insurance covers vary and depend on the plan and the policy type. Humana health insurance does cover residential and outpatient drug rehab. The benefit for outpatient drug rehab will vary by metal level, plan type, and other factors. Typically, out-of-network facilities are not covered. Drug detox like medication-assisted treatment or medical detox could also be covered. Some recovering addicts can also benefit from sober living homes being covered by Humana health insurance. Overall, there are differences between in-network and out-of-network providers. Humana maintains contracts with specific physicians and healthcare facilities. An in-network facility has a contract with Humana that specifies a pricing agreement. Out-of-network facilities do not have an established agreement with Humana. It is important for families to consider residential and outpatient drug rehab and look at multiple options.  


Family Intervention for Drug Addiction in California

Watching a loved one struggling with addiction is not easy, and without proper help, drug addiction becomes progressively worse. Professional family intervention in California motivates an addict to seek help for their drug addiction. Family intervention is a focused approach done with family, friends, and a professional interventionist to convince the drug-addicted family member to seek out treatment. Someone who is struggling with drug addiction is often in denial about their addiction and unwilling to seek treatment. Moreover, they may not recognize there is a problem despite family and friends pointing out the obvious. A family intervention presents the drug-addicted loved one with a structured opportunity to make changes before things get worse.

Family intervention is a carefully planned process with the help of a professional interventionist. During a family intervention, family, friends, and the interventionist come together to confront the drug-addicted loved one about the consequences of addiction and ask him or her to accept drug rehab. With the help of a professional interventionist, the family provides specific examples of destructive behaviors and their impact on the drug-addicted loved one and the family. An intervention offers prearranged treatment plans with clear steps, guidelines, and goals. Finally, the family intervention and the interventionist spell out what each person will do if the drug-addicted family member does not accept treatment. Overall, family intervention is a successful approach to consider, especially when an interventionist is hired to help.


Health Insurance for Drug Rehab and Drug Addiction Trends in California

In California, over 14,000 residents have Humana health insurance through a group plan or employer, and over 71,000 have Medicare health insurance through Humana. Within California, the uninsured rate has fallen from 17% to 7.1%, and the number of uninsured Californians has dropped by 3.7 million. Moreover, 1.5 million California residents get their coverage through Covered California. Unfortunately, in California, alcohol use disorders are more prevalent than other types of drug addiction. Approximately 6% of California residents met the criteria for alcohol addiction. Alcohol accounted for more nonfatal emergency department visits than all other drug diagnoses combined.



California Health Care Foundation. Health Insurance in California: A Recent History. December 2018. https://www.chcf.org/publication/health-insurance-california-recent-history/

California Health Care Foundation. How Many in Your Area are Covered by the Affordable Care Act. September 2020. https://www.chcf.org/publication/how-many-your-area-are-covered-affordable-care-act/