Networks change. We verify your specific Humana Medicare Advantage plan before your first visit; call with your member ID and we will confirm benefits, copay and any referral or authorization requirements.
Also appears on cards as: Humana Gold Plus, Humana Medicare, HumanaChoice PPO, Humana Gold Choice, Humana Dual SNP.
Humana is the largest or second-largest Medicare Advantage carrier in most Florida and South Carolina counties, and its Medicare book dwarfs its commercial business in both states. Humana Gold Plus HMO plans, HumanaChoice PPO plans, Humana Gold Choice private fee-for-service plans and dual-eligible special needs plans are all available in the counties around our offices. These plans cover outpatient psychiatry, medication management and psychotherapy for a fixed mental health copay, typically with no deductible, and most Humana HMO plans do not require a primary care referral for behavioral health, although members must stay in network. PPO members can go out of network at a higher cost share. Behavioral health is administered by Humana directly for most plans.
Telehealth mental health visits from home are typically covered at the same copay as office visits for members located in Florida or South Carolina during the appointment. For Deep TMS, Humana follows Medicare's coverage criteria for severe major depressive disorder after failure of at least two antidepressants and a psychotherapy trial, and it requires prior authorization on most Medicare Advantage plans, generally approving a standard course with continuation reviewed on documented response. Spravato is covered as a Part B drug with prior authorization, with documentation of treatment-resistant depression, a concurrent oral antidepressant and REMS-certified administration required. Per-session TMS copays and the cost share for Spravato drug and monitoring vary by plan, so our staff confirm your specific benefits before your first treatment.
What we check before your visit
- Whether your plan is in network at the office you chose and for telehealth
- Your copay or coinsurance for an evaluation and for follow-ups
- Whether a primary-care referral is required (common with HMO plans)
- Prior-authorization criteria for Deep TMS and Spravato, if those are being considered
Frequently asked questions
Does Stedfast Psychiatry accept Humana Gold Plus and HumanaChoice plans?
Stedfast Psychiatry accepts many Humana Medicare Advantage HMO, PPO and dual-eligible plans in Florida and South Carolina. Humana offers several plan designs in each county, and networks differ among them, so confirm that your specific plan includes our office by calling Humana or asking our front desk to verify before scheduling.
What will I pay for a psychiatry visit on Humana Medicare Advantage?
Most Humana Medicare Advantage plans charge a fixed copay for outpatient mental health visits with no deductible, and dual-eligible special needs plan members typically pay nothing. Telehealth visits usually carry the same copay. Your evidence of coverage lists the amount, and our front desk can confirm it before your visit.
Does Humana Medicare Advantage cover telehealth from home?
Yes. Humana covers video mental health visits from home for members located in Florida or South Carolina during the appointment at the same cost share as an office visit. This works well for medication follow-ups. Deep TMS and Spravato must be delivered in person at the offices that provide them.
Will Humana Medicare Advantage approve Deep TMS or Spravato?
Humana covers both under Medicare's criteria and requires prior authorization on most plans. TMS requires documented failure of at least two antidepressants and a psychotherapy trial; Spravato requires treatment-resistant depression and a concurrent oral antidepressant. Our Palm Beach Gardens TMS team and Spravato offices submit the request and confirm your cost share before scheduling.