Humana Healthy Horizons in Kentucky addiction treatment coverage
Humana Healthy Horizons covers the clinical continuum of substance use treatment for substance use disorder. Discuss your coverage with Golden Grove Recovery in Louisville, Kentucky.
What Humana Healthy Horizons is
Humana Healthy Horizons is Humana's Kentucky Medicaid managed care plan, serving members across all 120 Kentucky counties. The plan covers comprehensive substance use disorder treatment, behavioral health, and integrated care for members with co-occurring conditions. Humana Healthy Horizons also provides specialized supports for pregnant members and members transitioning out of incarceration.
What Humana Healthy Horizons covers for SUD treatment
- Residential SUD treatment (ASAM 3.1, 3.3, 3.5) based on ASAM medical necessity
- Partial Hospitalization (PHP, ASAM 2.5) and Intensive Outpatient (IOP, ASAM 2.1)
- Outpatient SUD therapy, group counseling, and relapse prevention
- Medication-Assisted Treatment — Suboxone, buprenorphine products, methadone, Vivitrol
- Integrated dual-diagnosis care for depression, anxiety, PTSD, and other co-occurring conditions
- Non-emergency medical transportation (NEMT) to SUD appointments
- Maternity programs that coordinate MAT for pregnant members (including Subutex)
Levels of care Humana Healthy Horizons covers
| ASAM | Description |
|---|---|
| 1 | Outpatient (ASAM 1) |
| 2.1 | Intensive Outpatient (ASAM 2.1) |
| 2.5 | Partial Hospitalization (ASAM 2.5) |
| 3.1 | Clinically Managed Low-Intensity Residential (ASAM 3.1) |
| 3.3 | Clinically Managed Population-Specific High-Intensity Residential (ASAM 3.3) |
| 3.5 | Clinically Managed High-Intensity Residential (ASAM 3.5) |
MAT covered by Humana Healthy Horizons
Humana Healthy Horizons covers the following FDA-approved medications for opioid and alcohol use disorder:
SuboxoneSubutexMethadoneVivitrolOral Naltrexone
Read more about how Medicaid covers MAT, including authorization and pharmacy benefits.
How prior auth works with Humana Healthy Horizons
Humana Healthy Horizons typically requires prior authorization for residential SUD admissions and concurrent review for continued-stay authorization. MAT prescriptions may be subject to pharmacy prior authorization depending on the specific medication.
Member benefits that apply to SUD
Members have access to Humana's Care Management program, a 24/7 nurse advice line, pharmacy benefits through Humana's formulary, and specialty programs for high-risk pregnancy and SUD.
More on Humana Healthy Horizons at https://www.humana.com/medicaid/kentucky.
Talk to admissions about Humana Healthy Horizons coverage
Call us or send a message — we'll discuss what your Humana Healthy Horizons plan covers and the next step.
Frequently asked questions
Does Humana Healthy Horizons cover residential addiction treatment?
Yes. Humana Healthy Horizons covers residential SUD treatment (ASAM 3.1, 3.3, 3.5) based on medical-necessity determination using ASAM criteria. Prior authorization with concurrent review is typical.
Does Humana Healthy Horizons cover Suboxone or methadone?
Humana Healthy Horizons covers Suboxone, Subutex, Methadone, Vivitrol, Oral Naltrexone as part of its MAT benefit. Methadone is delivered through licensed opioid treatment programs (OTPs).
Will Humana Healthy Horizons cover medical detox?
Kentucky Medicaid plans cover medical withdrawal management when medically necessary, with coverage details that vary by level of care and setting. If detox is part of your situation, talk to our admissions team about the right path for you.
What does prior authorization look like with Humana Healthy Horizons?
Humana Healthy Horizons typically requires prior authorization for residential SUD admissions and concurrent review for continued-stay authorization. MAT prescriptions may be subject to pharmacy prior authorization depending on the specific medication.
Is Golden Grove Recovery in-network with Humana Healthy Horizons?
Golden Grove Recovery is in pre-opening setup. The information on this page is provided to help you understand Kentucky Medicaid coverage for substance use treatment. Contact our admissions team to discuss your individual situation and treatment options.