Networks change. We verify your specific Humana 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 Commercial, Humana Gold Plus, Humana Medicare.
Humana is headquartered in Louisville but has one of its largest memberships in Florida, where it offers Medicare Advantage plans, employer group plans and TRICARE East administration through Humana Military. Most Stedfast Psychiatry patients with Humana are on a Medicare Advantage HMO or PPO. Those plans cover outpatient psychiatry for a specialist copay, commonly $0 to $50, and Humana HMO plans typically require you to use network providers but do not require a primary care referral for mental health. Humana commercial group plans cover psychiatry under standard specialist cost sharing. Telehealth psychiatry is covered at parity for members in Florida and South Carolina, and Humana Medicare Advantage plans have continued covering video mental health visits from home.
Humana follows Medicare's local coverage determination for transcranial magnetic stimulation on its Medicare Advantage plans, covering TMS for major depressive disorder after failure of at least two antidepressants, with prior authorization required and a standard course approved. Its commercial plans apply a similar medical policy. Spravato is covered with prior authorization, with Medicare Advantage members paying a Part B style cost share for the drug and the monitoring visit, and commercial members paying according to their plan. Our staff handle Humana authorizations for TMS and Spravato routinely.
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 Medicare Advantage?
Stedfast Psychiatry accepts many Humana Medicare Advantage HMO and PPO 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 staff to verify before scheduling.
What will I pay for a psychiatry visit on Humana?
Humana Medicare Advantage plans usually charge a fixed specialist copay for outpatient mental health, often between $0 and $50 per visit, with no deductible. Commercial group plans charge the specialist copay or coinsurance shown in your benefits summary. Our front desk can tell you the exact amount for your plan before your visit.
Does Humana cover telehealth psychiatry from home?
Yes. Humana covers video mental health visits from home for Medicare Advantage and commercial members located in Florida or South Carolina during the appointment, at the same cost share as an office visit. This is useful for follow-up medication visits. TMS and Spravato must be delivered in person at the offices that provide them.
Will Humana approve Deep TMS?
Humana covers TMS for major depressive disorder with prior authorization when you have documented failure of at least two antidepressants and current severity scores. Medicare Advantage plans apply Medicare's coverage criteria. Our TMS coordinator at Palm Beach Gardens submits the request, and approvals typically allow the full 36-session course.
Does Humana cover Spravato for treatment-resistant depression?
Humana covers Spravato with prior authorization when you have treatment-resistant depression and are taking an oral antidepressant. Medicare Advantage members pay a Part B style cost share for the drug and the monitored visit, which can be meaningful, so ask our staff for an estimate. Treatment occurs at our certified Boynton Beach, Palm Beach Gardens and Royal Palm Beach offices.