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Coverage and Your Way Out of the Chaos

sex-addictionUntil recently, obtaining coverage for sex and love addiction was a hit and miss affair, based on sketchy science and the DSM-IV’s lack of diagnostic criteria. Today, your coverage is not quite as free and easy as it would be if you were, for example, a heroin addict, but new trials and some DSM-V changes have made the system somewhat easier to navigate. There is no one answer to whether or not Humana will cover you under your policy for treatment, but with some resourcefulness and a motivated psychiatrist at your side, it’s quite possible. You will need to prove that behavioral addiction is a proven clinical entity as trials have suggested, or work under the weight of a DSM-V diagnosis of avoidant personality disorder. With these criteria, you receive coverage as an essential benefit.

Securing Coverage for Your Unique Treatment Strategy

Medical necessity criteria determine the kinds of therapies you’re covered for. Policies generally use The Mihalik Group’s Medical Necessity Manual for Behavioral Health to help your primary care doctor prove your need for coverage. Your task is not to wade through complex diagnoses and clinical charts but rather to be honest during your clinical assessment and determined in your requests for help securing coverage. You may complete the Sexual Addiction Screening Test, which determines your behaviors and the lifestyle that drives them. This will help to solve the riddle of whether your need is for 12-step rehab, psychotherapy or inpatient psychiatric care.

Out-of-Pocket Costs

Most Humana policies are shielded by an out-of-pocket limit capping your expenses. You receive 100 percent coverage after that limit has been reached, but your plan may be defined by a list of co-pays, each of which will be attached to its own treatment. Deductible plans require you to pay a set amount before you receive coverage. Choosing a preferred provider secures you a cost that Humana will have negotiated down, mitigating your co-pay to a figure that’s easier to stomach.

The Freedom to Veer Out-of-Network

Balance billing is the term for the charge you pay when you use an out-of-network provider. You are billed the difference between the allowed amount and the cost of the treatment you decide on. This is one way to gain the freedom to choose facilities that aren’t found on Humana’s preferred provider list. Humana Insurance for sex addiction rehab doesn’t cover out-of-network providers in all plans and not all policies limit you to networks, giving you freedom to pay out of pocket and still gain coverage.

Inpatient Addiction Treatment vs. Outpatient Therapy

" There is no one answer to whether or not Humana will cover you under your policy for treatment, but with some resourcefulness and a motivated psychiatrist at your side, it’s quite possible."
Sex and love addiction has real risks that are often sidetracked when viewed purely as dependencies equal to any other. Shame is a particularly important consideration when selecting treatment: Addicts must feel they can share honestly, yet the fear of being shamed can be starkly different to that faced by chemical addicts. Inpatient care puts you into group therapy, and having the capacity to hear others speak can embolden your own honesty. Other patients may feel more secure sharing only in one-on-one therapeutic treatment. Behavioral screening is a tool that may lead you best towards your needed mode of care. Psychosocial treatments are generally available through residential rehab facilities, although specialized sex addiction centers offer intensive care targeted directly at fundamental triggers and choices. As an outpatient, these programs are also possible, as are cognitive behavioral therapy and psychodynamic therapy.

Gaining Coverage Out-of-State

Humana Insurance for sex addiction — love and intimacy disorders rehab is an established group of policies that has achieved stellar ratings across the board. Its policies are relatively slack, giving you a fair degree of freedom to choose out-of-state care. You may use Humana’s network of providers to gain more budget-friendly care while away. In emergencies, you are free to use any provider. Their MyHumana system is a resource rich source of preferred providers in all of the 50 states it operates in.

Coverage for Private and Luxury Treatment

Humana insurance for sex addiction—love and intimacy disorders treatment usually lets you use private care either through its Preferred Provider Network or out-of-network centers. When you choose an in-network facility, you cannot be balance billed but you are likely to pay a co-payment or deductible depending on your plan. With medical necessity fuelling your coverage, it can be difficult for lower tier plans to gain coverage for luxury treatment but your plan may give you the freedom to pay extra out-of-pocket costs for it.

Executive Treatment

Your sociological and practical needs are a central part of your outcome. Executive care keeps your sensitive case out of the public eye while giving you the office equipment needed to keep you functional. Premium executive treatment should address more than simply these issues: process addictions can swing, leaving you with a work addiction in exchange for your intimacy disorder. Executive care should be conscientious of this risk, and also able to address the character traits that your corporate success and addiction have spurned together.

Treatment Lengths

Your healthcare provider should always be the nucleus of your treatment strategy. He will advocate for you to prove medical necessity and, if necessary, plead your case if your claim is rejected. If your goal is to complete a 60 or 90 day program that isn’t automatically covered in your plan, a letter of medical necessity will help you to gain coverage.

What If I Have No Insurance?

insurance-and-addictionIf you feed as much effort into finding treatment as you did into your addiction, you will be able to put yourself through treatment without insurance. Your options are numerous: government centers are often free of charge, and psychotherapists often take on a number of pro bono cases annually. Federal funding and private rehab financing can also be boons. The question, “How free do you want to be?” is something therapists ask their patients when gaging their willingness to do what’s necessary to recover. If your answer is, “Utterly free,” call 1-888-341-7785 so that we can find your treatment niche and advise you on your coverage.

Questions and Answers

  • Will Humana Insurance Cover Multiple Rehab Stays?
  • Humana insurance coverage for sex addiction — love and intimacy disorders rehab/treatment is subject to annual limits. Some plans are exceedingly generous with the treatment days covered annually while others limit you to acute inpatient rehab. Nonetheless, it is always possible to apply for additional treatment. Each time you reapply, your odds of gaining coverage rise.

  • Does Insurance Pay for Aftercare?
  • Humana covers aftercare in cases with defined addiction diagnoses but love and intimacy disorders may require a disparate treatment strategy. Your psychiatrist may decide that your relapse prevention plan will be better reinforced by counselling and group therapy. If, however, you do gain coverage for primary treatment under a diagnosis of sex addiction, LifeSynch’s behavioral health managers are unlikely to deny you coverage for aftercare.

  • Could Rehab Make My Insurance Premiums Higher?
  • Health care costs and premiums will always rise in tandem, but your costs may not be increased due to anything except health-damaging modifiable behaviors such as tobacco use and poor eating choices. Rehabilitation itself is not a legally acceptable reason to hike up your costs.

  • Has the Affordable Care Act (Obamacare) Affected Substance Abuse and Mental Health Insurance Coverage?
  • The mental health mandate under Obamacare pushes your psychiatric diagnosis onto a list of essential benefits that your insurer must cover. Your rehabilitation will also be more integrated, blending treatments for psychiatric disorders and dependency care into a single process.

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