Humana Behavioral Health Care Management

Behavioral health issues and medical conditions often go hand in hand. An unexpected medical diagnosis or the fatigue related to a chronic condition may create emotional discord, leading to behavioral health concerns presented in a primary care setting. Humana Behavioral Health (link opens in new window), a wholly owned subsidiary of Humana, offers the Humana Behavioral Health Care Management program to assist with Humana members' behavioral health issues. The goal of the program is to improve members' adherence to their physicians' treatment plans by addressing underlying behavioral concerns and facilitating life behavior changes to better manage medical health. These changes may result in increased positive health outcomes, as well as improvements in productivity and overall quality of life.

Program overview

Humana Behavioral Health care managers are behavioral clinicians and nurses who provide telephone-based case management for members. Through motivational interviewing, positive psychology, solution-oriented approaches and crisis support techniques, advocates work to:

  • Empower members to manage their behavioral symptoms
  • Guide members in identifying sustainable solutions to their symptoms
  • Educate members about their illness(es) and effective treatments if they show limited knowledge about how to obtain outcome-changing care
  • Develop a personalized care plan for each member, engaging the member and appropriate support systems in the process
  • Connect members with other available care management benefit providers to foster continued improvement
  • Advocate for each member’s needs and goals by understanding and respecting the member’s value system while searching for necessary funding, appropriate treatment and treatment alternatives
  • Integrate medical and behavioral components of treatment to produce long-lasting results.

Care managers may also facilitate conference calls between a member and his or her primary care or behavioral health provider if the member signs a release-of-information form.

This program is accredited by the Utilization Review Accreditation Commission (URAC).

Eligibility and cost

The program is part of select medical benefit plans and is provided at no additional cost to eligible members of these plans. Humana identifies eligible members and contacts them by telephone to offer them the opportunity to participate in the program.

The following members may be eligible for Humana Behavioral Health Care Management:

  • Medicare Advantage members
  • Commercial health maintenance organization (HMO) members
  • Commercial preferred provider organization (PPO) members
  • Members of administrative-services-only groups that have purchased this benefit

This program is not available to Puerto Rico members, Florida Medicare Advantage HMO and PPO members or Nevada Medicare Advantage HMO members.

More information

For more details about Humana Behavioral Health Care Management, call 1-866-952-6028 and select the option for behavioral health referrals. This line accepts service requests from members, authorized representatives, behavioral health practitioners and health care providers.