Humana Coverage for Bulimia Treatment

Still, eating disorder treatment is often lengthy and expensive, with most people needing insurance coverage to help them pay for these programs.

If you have an insurance policy through Humana, you’ll likely have access to coverage for BN treatment and the treatment of other eating disorders through the company’s behavioral health services. But, as with all insurance plans, there will likely be a number of nuances and caveats involved.

For the most specific information on what you can and can not expect to have covered, you’ll need to consult your insurance policy or contact a Humana representative.

Does Humana Cover Eating Disorder Treatment?

Generally, Humana health insurance plans offer some level of mental and behavioral health coverage, which can be used to pay for a number of treatments and diagnostic procedures used for eating disorders.

As with most insurance plans, you will typically need to be diagnosed by a mental health professional in order to fully benefit from your coverage. In some cases, your primary care doctor can offer this diagnosis, though many insurance companies require the diagnosing doctor to be in-network. [1]

The exact level of coverage for BN treatment with Humana will depend on the specific plan you hold. Higher-tiered plans, which generally require higher monthly premiums, usually cover mental health services at higher rates than lower-tiered plans that require smaller monthly payments.

What Will Humana Cover for Bulimia Treatment?

By and large, health insurance companies will only extend coverage for certain types of treatment. Generally, they require care to be considered medically necessary and evidence-based, or seen in the medical community as widely effective.

What Will Humana Not Cover for Bulimia Treatment?

As with a majority of health insurance companies, Humana is unlikely to cover treatments it does not consider medically necessary, based on a patient’s diagnosis and the severity of their symptoms. The company may also resist if there is a cheaper, yet arguably comparable, alternative available. This is most often seen as the coverage of generic vs. name-brand medications.

Coverage likely also won’t be extended to treatments considered experimental or not otherwise backed by enough medical evidence. It may be possible to argue against these decisions, but that will require the cooperation and advocation of your primary care physician, along with possible additional paperwork and bureaucratic procedures, with no guarantee of approval. 

Likewise, coverage for inpatient eating disorder treatment or even some intensive outpatient programs may also require some fighting on your behalf. As these programs are generally more expensive and lengthy, they often require a high burden of proof that they are medically necessary. [3] Some insurance plans may require you to try outpatient services before they will approve of a residential eating disorder treatment program.

To get the best idea of what your Humana plan will or will not cover, you should consult your specific policy or speak with a company representative.

How to Start the Treatment Process Using Humana Coverage

Once you have a plan with Humana, you will typically want to begin by getting an official medical diagnosis for BN and any co-occurring disorders. The company may require the diagnosing physician to be in-network, so take care to clear that up before making an appointment.

Once you have a diagnosis, you and your treatment team can start building a treatment plan. Along with the official diagnosis, this will be used by the insurance company to help determine the types of care eligible for coverage.

Once again, when looking into programs, whether for outpatient treatment or inpatient care, it’s important to keep your insurance company network in mind. Most plans will only offer limited coverage, or no coverage at all, for out-of-network physicians and facilities.

Finding Bulimia Treatment Centers in Humana’s Network

You can start your search for in-network doctors and treatment facilities with Humana itself. The company’s website offers details on how best to find in-network treatment providers. You can also speak directly to a company representative by calling the member services number on the back of your Humana ID card.

If you prefer, you can start your search by looking for specific treatment programs you want to enroll in. But it’s paramount in these cases to ensure, through either Humana or directly through the program, that they will take your insurance in order to avoid any surprise bills in the future.

Dealing with the complexities of insurance coverage is likely the last thing someone struggling with an eating disorder wants, but taking this step in the beginning will help ensure you steer clear of confusion or frustration down the line and help make the road to recovery as smooth as possible.