Deciding to take the first step toward recovery through drug and alcohol rehab is an important milestone, and one that should be applauded. Sadly, however, a staggering number of individuals decide against this treatment because they are worried about things like cost and insurance acceptance. For those with Humana health insurance, there are a number of options available. Understanding more about rehab and insurance coverage can make it easier for prospective patients to commit to recovery.

The Role of the ACA on Health Insurance and Rehab

Before diving into the specifics of what a Humana health insurance policy might cover, it is important to understand how the Affordable Care Act has changed rehab coverage across the board. The Affordable Care Act, better known as the ACA, mandates that all health insurance providers offer minimum benefits to their policyholders. This impacts things like the treatment of addiction as a disease, no discrimination against those with pre-existing conditions, and a mandatory minimum level of rehab support and payment.

For individuals struggling with addiction who want to seek help, the ACA has made things much easier than ever before. To start, Humana can’t deny any patients rehabilitation treatment. Substance abuse is now legally defined as an illness, and it has to be treated in the same way that a diagnosis of heart disease or asthma might be.

In addition, patients who have already struggled with addiction in the past can’t be denied more treatment because of a so-called pre-existing condition. These same patients can’t be denied health insurance from Humana, or from any other provider, just because they have a history of addiction or any other physical or mental health problems.

The ACA has forced the answer to the question of whether a Humana health insurance policy will cover rehab. In short, the answer is now a resounding yes. Of course, there are limitations on what kind of coverage is available, and those details will depend on the individual health insurance policy.

Individual Humana Health Insurance Policies

Health insurance policies from Humana can vary significantly, and each will have different limitations and restrictions on what kind of addiction treatment is covered and what isn’t. Things like duration, network and deductible are the three main things to keep in mind.

The first is duration, and that is important to consider because it can impact the kind of rehab patients seek. In some cases, a Humana health insurance policy will clearly state that it will cover up to 21, 30 or 60 days of rehab. In other cases, a policy will cover 100 percent of outpatient programs, but only 60 percent of inpatient programs. Learning the specifics of an individual policy can make it easier to select the right rehab program.

Network refers to the range of suppliers that are accepted by or compatible with the insurance provider, which in this case would be Humana. Some policies specifically cover only rehab providers that are within their network. Alternatively, they may only reimburse patients for completed out-of-network programs after the fact, or they may cover only a set percentage of total costs.

Finally, deductible is a crucial element in determining coverage eligibility for drug & alcohol rehab with Humana insurance. The deductible is the amount that policyholders will pay before coverage can begin. This deductible is clearly stated for every individual Humana health insurance policy, and it typically ranges from $0 to $5,000. In some cases, patients will need to pay the amount of the deductible before rehab coverage kicks in.

Type of Rehab Program May Impact Coverage

While most prospective patients look specifically at the Humana health insurance policy when determining eligibility for rehab coverage, it is just as important to take a look at the specific type of rehab program. After all, rehab programs for the treatment of drug and alcohol addiction can vary in terms of cost, luxury, duration and method.

Often, Humana and other major health insurance providers only cover rehab when it is offered at an accredited facility. Programs that are verified by the Joint Commission, in particular, meet the high standards set by most health insurance companies.

It is also common for individual health insurance policies to stipulate that rehab must be a certain type of program in order to be covered. Often, policies only cover outpatient rehab. This is because inpatient or residential care is often more expensive, thanks to the additional costs of accommodation for patients.

Paying for What Humana Insurance Won’t

Even if Humana health insurance policies can’t cover the full cost of a specific drug and alcohol addiction program, there are still ways to get the necessary help for sobriety. Many patients seek out loans from friends or family members, and even banks offer specific treatment loans for those in need of rehab. Prospective patients should also ask rehab facilities what opportunities they offer, since many programs will allow patients to pay in installments, receive need-based scholarships or offer in-house financing options.

Verifying Humana Coverage for a Specific Rehab Program

Ultimately, coverage can’t be guaranteed until prospective patients have looked at their individual policy, spoken with representatives of the health insurance company and also contacted the rehab provider. It is always important to verify and confirm coverage before enrolling in a rehab program. By guaranteeing a minimum level of coverage up front, patients can focus on their recovery rather than their finances.

Once coverage from Humana is confirmed, it is time to prepare for rehab. In some cases, patients will begin with a drug or alcohol detox program before moving to a formal rehab facility. In other instances, these two services may be provided together in a single facility.

Thanks in large part to the enactment of the Affordable Care Act, drug and alcohol rehab is now a standard feature of health insurance coverage from Humana and other health insurance providers. Since there are so many variables with individual policies, it is important to take a look and see what is covered with regard to rehab type, duration of treatment and network.

It’s very common for those with mental health problems to begin struggling with addiction, and just as common for those who are addicted to various substances to begin experiencing mental health problems. Therefore, the best addiction treatment will be one that understands the role of dual diagnosis and the clear link between mental health and addiction recovery.

Determining if Dual Diagnosis is Necessary

The first step creating a treatment plan that deals with mental health and addiction is determining whether dual diagnosis truly is necessary. In some cases, patients who are struggling with mental health concerns are only doing so because these symptoms are a side effect of addiction. For instance, patients addicted to strong sedatives may be depressed, but that could be a common symptom of the drug rather than a pre-existing concern.

To determine whether patients are eligible candidates for dual diagnosis treatment, the first step is a complete evaluation upon admission to a detox program. However, this shouldn’t be the only time dual diagnosis is analyzed. After detox, and before rehab begins, is the optimal time to take a closer look at the mental health of patients. Since there won’t be any physical symptoms of drug or alcohol use to contend with at this stage, it will be easier to pinpoint any standalone mental health concerns such as depression, anxiety, PTSD, bipolar disorder or schizophrenia.

Getting a Comprehensive View of Health and Recovery

Patients who begin down the road to recovery are often focused on one goal—getting sober. Achieving and maintaining sobriety is an admirable objective, but focusing on the physical symptoms alone may not be enough. A more comprehensive approach to wellness means taking mental health into consideration as well. Often, that means pinpointing and treating mental health problems in addition to addictive behaviors.

There are many different theories on what links mental health disorders and the frequency of addictive behaviors. Some research suggests that those struggling with mental health disorders, and who aren’t getting the medical help they need, are more likely to turn to drugs or alcohol as a means of self medication. Of course, suffering from addiction is likely to exacerbate the symptoms, making the situation worse.

Conversely, addiction itself can lead to mental health disorders. When individuals become addicted to drugs or alcohol, they can experience feelings like guilt or shame, which can in turn create internal stress and serious mental health problems. In environments where addiction is common, individuals may also be at higher risk for crimes like rape or physical abuse, and that can further increase the likelihood of trauma.

How Dual Diagnosis Can Prevent Relapse

One of the primary objectives of any rehab program is to help patients prevent a relapse. A relapse is anytime that the addictive substance is used again after treatment, and it’s a common problem. However, there are ways to reduce the likelihood of relapse, one of the most effective being dual diagnosis treatment.

A few common triggers for relapse are things like stress, guilt, shame, unhappiness or anger. Many mental health professionals will immediately recognize that these are common emotions among those who also struggle with things like PTSD, anxiety, bipolar disorder and depression.

When patients are dealing with the effects of a mental health problem, relapse is far more likely. When patients receive the right treatment for their mental health challenges, however, they will be more cognitively aware, better prepared and generally more able to fight back against cravings. Dual diagnosis treatment can help patients realize that staying sober is truly the best choice in the long run.

Treating Addiction and Mental Health Disorders Simultaneously

When medical professionals at addiction treatment centers know that patients require attention for both their addictive behavior and their mental health, they can offer simultaneous treatment. Often, this involves some form of prescription medication. Certain medications can lessen or even eliminate the symptoms of mental health problems, such as anxiety. When patients have resolved their mental health issues, they may find that they are no longer as emotionally reliant on their addictive substance of choice.

There are also a number of behavioral therapies that can be effective in treating both addiction and mental health disorders. Cognitive behavioral therapy, for instance, seeks to alter behaviors and make positive changes that benefit patients. Dialectical behavioral therapy emphasizes the value of self and helps patients see their worth and why staying sober is something they deserve. Group therapy can also be effective in limiting feelings of isolation and helping patients to understand there are many other people who share their emotions and their experiences.

Revealing the Underlying Causes

Mental health disorders and addiction can be linked through underlying causes, and in some cases triggers may be partially to blame for both. Past trauma, and in particular PTSD, may be the root of some problems. Children who were victims of assault, for example, could grow up with mental health disorders as well as feelings of inadequacy. Or, they may wish to stop reliving painful memories.

In these cases, drug or alcohol abuse is a way for patients with mental health problems to seek peace. In reality, of course, addiction rarely solves a problem, and usually only adds to it. Often, patients with both mental health disorders and problems with addiction can undergo therapy that confronts underlying causes and helps tackle both issues at the same time. EMDR, or eye movement desensitization and reprocessing, has shown to be effective for this purpose.

Dual diagnosis is integral for patients in need of addiction treatment who also have mental health concerns. By treating both issues simultaneously, with the goal of comprehensive health, patients are more likely to achieve lasting sobriety and more likely to find happiness, health and fulfillment in daily life.