Humana Mental Health Coverage Guide

Does Humana Cover Therapy?

Yes, Humana covers therapy. Humana serves over 17 million medical members nationwide and provides comprehensive mental health coverage across its commercial, Medicare Advantage, and Medicaid plans. Under the Mental Health Parity and Addiction Equity Act, Humana is required to cover mental health services at the same level as medical and surgical benefits.

Humana has a particularly strong presence in the Medicare Advantage market, making it a major provider of mental health benefits for older adults. The company has also expanded access to telehealth behavioral health services in recent years, giving members more ways to connect with therapists.

If you are new to therapy, our therapy for beginners guide can help you understand what to expect.

Types of Therapy Covered by Humana

Humana plans typically cover a wide range of mental health services when provided by a licensed professional:

• Individual therapy — one-on-one sessions billed under CPT codes 90834 (45 minutes) or 90837 (60 minutes)
• Group therapy — sessions with multiple participants led by a licensed therapist (CPT 90853)
• Family therapy — sessions involving family members with a diagnosed patient present (CPT 90847)
• Psychiatric evaluation — initial diagnostic assessment (CPT 90791)
• Medication management — ongoing sessions to monitor and adjust psychiatric medications
• Substance use treatment — outpatient counseling and structured programs for addiction

Covered evidence-based treatment approaches include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), EMDR, acceptance and commitment therapy (ACT), and exposure and response prevention (ERP).

Humana provides coverage for conditions including anxiety, depression, PTSD, OCD, bipolar disorder, eating disorders, grief, insomnia, and substance use disorders.

In-Network vs. Out-of-Network Coverage

Your therapy costs with Humana depend significantly on whether your provider is in-network.

In-Network Therapists

When you see a therapist in Humana's provider network:

• Lower copays — typically $20 to $50 per session for commercial plans
• Negotiated rates — Humana has pre-arranged fees with in-network providers
• No balance billing — in-network providers accept Humana's approved amount
• Direct claims processing — your therapist files claims with Humana on your behalf

Out-of-Network Therapists

If you have a Humana PPO plan, you may have out-of-network benefits:

• Higher deductible — out-of-network deductibles are typically higher than in-network
• Higher coinsurance — expect to pay 30% to 50% of Humana's allowed amount
• Balance billing — out-of-network therapists can charge more than Humana's allowed amount
• Superbill reimbursement — you pay the full session fee and submit a superbill for partial reimbursement

Humana HMO plans generally do not cover out-of-network services except in emergencies. Medicare Advantage HMO plans also typically require in-network providers.

For a thorough overview of payment options, see our guide to paying for therapy.

How to Find In-Network Therapists

Humana provides several tools for locating in-network behavioral health providers:

1. Humana provider directory — Visit Humana's Find a Doctor tool and search for behavioral health providers by location and specialty. Enter your member ID for plan-specific results.

2. MyHumana portal — Log into Humana's member portal to search for providers and review your specific benefits.

3. MyHumana app — Search for providers and manage your care on the go with Humana's mobile app.

4. Call member services — Contact Humana at 1-800-457-4708 or the number on your insurance card for assistance finding in-network therapists.

5. Medicare Advantage members — If you have a Humana Medicare Advantage plan, use the Medicare-specific provider search at humana.com and select your specific Medicare plan to see accurate network information.

For more guidance on choosing the right therapist, our guide on how to find a therapist covers what to consider.

Common Copays and Deductibles

Humana therapy costs vary by plan type. Here are typical ranges:

Commercial Plans

Medicare Advantage Plans

Medicare Advantage plans through Humana often offer more generous behavioral health benefits than traditional Medicare, including lower copays and additional telehealth options. Some plans include supplemental benefits specifically for mental health.

Many Humana employer-sponsored plans include an Employee Assistance Program (EAP) with free therapy sessions. Check with your HR department to see if EAP benefits are available.

Mental Health Parity Information

Federal law protects Humana members' access to mental health services:

• Equal financial requirements — copays, deductibles, and coinsurance for therapy must be comparable to those for medical care
• No discriminatory visit limits — Humana cannot impose session caps on mental health treatment that are stricter than limits on medical visits
• Adequate provider networks — Humana must maintain sufficient behavioral health providers to serve its membership
• Consistent authorization standards — preauthorization requirements for mental health must be applied equally with medical services

For Medicare Advantage members, additional protections apply under Medicare regulations. Medicare requires coverage of outpatient mental health services, and Humana Medicare Advantage plans must meet Centers for Medicare and Medicaid Services (CMS) network adequacy standards.

If you believe your mental health benefits are being applied unfairly, you can file a grievance with Humana, contact your state insurance department, or (for Medicare Advantage plans) contact CMS at 1-800-MEDICARE.

Pre-Authorization Requirements

Humana generally does not require prior authorization for routine outpatient therapy. Most members can schedule and begin therapy without seeking approval first.

Prior authorization is typically required for:

• Residential treatment programs
• Inpatient psychiatric hospitalization
• Electroconvulsive therapy (ECT)
• Transcranial magnetic stimulation (TMS)
• Intensive outpatient programs (IOP)
• Partial hospitalization programs (PHP)

If your therapist recommends a higher level of care, they will typically initiate the prior authorization process. For standard outpatient therapy — individual, group, and family sessions — no authorization is needed for most Humana plans.

Medicare Advantage members should be aware that some Humana MA plans may have different authorization requirements. Check your Evidence of Coverage document for plan-specific details.

Telehealth and Online Therapy Coverage

Humana covers telehealth therapy for most plan members, including both commercial and Medicare Advantage plans:

• Same copay as in-person — most Humana plans apply the same cost-sharing to virtual and in-person therapy sessions
• Video and phone sessions — both video-based and audio-only telehealth are widely covered
• Medicare Advantage telehealth — Humana has expanded telehealth benefits for Medicare Advantage members, making virtual therapy accessible to older adults
• Provider flexibility — many in-network Humana therapists offer both in-person and telehealth appointments
• No geographic restrictions — virtual sessions are available anywhere you have an internet connection, though your therapist must be licensed in your state

Telehealth is particularly valuable for Humana Medicare Advantage members who may face mobility challenges or live in rural areas with limited mental health providers.

Tips for Maximizing Your Humana Benefits

1. Verify benefits before starting — Call member services or log into MyHumana to confirm your specific behavioral health benefits, including copay amounts and deductible status.

2. Use the right provider search for your plan — Humana has different provider networks for commercial, Medicare Advantage, and Medicaid plans. Make sure you are searching the correct directory for your plan type.

3. Take advantage of $0 copay options — Some Humana Medicare Advantage plans offer $0 copays for behavioral health visits. Check your plan's Summary of Benefits to see if this applies to you.

4. Consider telehealth — Virtual appointments may offer more scheduling flexibility and quicker access to care, particularly for Medicare Advantage members.

5. Use EAP if available — Employer-sponsored Humana plans may include free EAP therapy sessions. Use these before dipping into your regular benefits.

6. Submit out-of-network claims through MyHumana — If you have out-of-network benefits, submit superbills through the MyHumana portal or by fax to 1-877-260-3498. Include all required information for fastest processing.

7. Use HSA or FSA funds — Therapy costs are eligible expenses for Health Savings Accounts and Flexible Spending Accounts. This includes copays, coinsurance, and deductible payments.

8. Appeal denied claims — If Humana denies a claim or authorization, request the denial reason in writing and file an appeal. Include documentation from your therapist supporting medical necessity.

For more strategies on affording therapy, see our guide to paying for therapy.

FAQ

Does Humana require a referral for therapy?

Most Humana PPO plans allow direct access to therapists without a referral. Humana HMO plans may require a referral from your primary care physician. Medicare Advantage plans vary by plan type — HMO plans may need a referral, while PPO plans typically do not. Check your plan documents or call member services.

How many therapy sessions does Humana cover?

Under the Mental Health Parity Act, Humana cannot impose session limits that are more restrictive than limits on comparable medical services. Most Humana commercial plans do not have annual session caps for outpatient therapy. Medicare Advantage plans follow Medicare guidelines, which generally do not limit outpatient mental health visits.

Does Humana cover therapy for seniors?

Yes. Humana is one of the largest Medicare Advantage insurers in the country, and all Humana Medicare Advantage plans cover outpatient mental health services. Many plans offer favorable terms for behavioral health, including low or $0 copays. Seniors can access therapy for conditions like depression, anxiety, grief, and insomnia.

Does Humana cover couples therapy?

Humana covers family and couples therapy (CPT 90847) when one partner has a diagnosed mental health condition and the therapy is billed under that individual. Pure relationship counseling without a clinical diagnosis is generally not covered. Discuss billing with your therapist.

Does Humana cover substance abuse treatment?

Yes, Humana covers substance use disorder treatment as required by federal law. This includes outpatient counseling, intensive outpatient programs, residential treatment, and medication-assisted treatment. Prior authorization is typically required for levels of care beyond standard outpatient therapy. Learn more about addiction treatment.

Can I see a therapist online with Humana?

Yes. Humana covers telehealth therapy for most plan members, including Medicare Advantage members. Virtual sessions typically carry the same copay as in-person visits. Many in-network Humana therapists offer telehealth appointments. Check the provider directory or call member services to find therapists who offer virtual sessions.