Certifications and accreditations

Humana is certified by the Committee on Operating Rules for Information Exchange (CORE) and accredited by the National Committee for Quality Assurance (NCQA). With CORE certification, Humana joins others in standardizing the information insurers send to providers. NCQA standards are intended to help organizations achieve the highest level of performance possible, reduce patient risk and create an environment of continuous improvement.

CORE is an initiative by a nonprofit alliance of health plans, networks, and trade associations to simplify healthcare administration. With CORE, providers get consistent, uniform information from each insurer.

CORE’s mission is to establish operating rules that make electronic transmissions of information about patients more predictable—regardless of how they are transmitted—to:

• Improve the quality of interactions between health insurers and providers
• Encourage confidence and trust between insurers and providers
• Reduce costs
• Reduce administrative hassle
• Meet Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirements and other standards
• Improve accuracy and speed in paying claims
• Encourage integration of clinical data

The National Committee for Quality Assurance (NCQA) is a private, not-for-profit organization dedicated to improving healthcare quality. NCQA strives to transform healthcare quality through measurement, transparency, and accountability.

NCQA evaluates the quality of key processes and systems that health plans provide their members. NCQA sends a team of trained healthcare experts, including physicians, to conduct a rigorous on-site survey of each health plan being considered for accreditation.

• Health Plan Accreditation
  • Humana Insurance Company –
    • Commercial PPO: Kansas, Missouri, Illinois, Texas, and Wisconsin
    • Medicare PPO: Arizona, Illinois, Kansas, Kentucky, Missouri, Ohio, Tennessee, Texas, Utah and Wisconsin
  • Humana Medical Plan, Inc. (Florida) – Commercial HMO/POS, Medicare HMO
  • Humana Medical Plan, Inc. (also known as Humana Healthy Horizons in Florida) – Medicaid HMO
  • Humana Health Plan of Texas, Inc. – Commercial HMO/POS
  • Humana Health Plan, Inc. –
    
    • Commercial HMO/POS: Arizona, Colorado, Kentucky, Kansas, Missouri, Illinois, Tennessee
    • Medicare/Medicaid Dual Demonstration: Illinois
    • Commercial PPO: Kentucky
  • Humana Health Plan, Inc. (also known as Humana Healthy Horizons in Kentucky) – Medicaid HMO
  • Humana Wisconsin Health Organization Insurance Corporation –
    • Commercial HMO/POS: Wisconsin
    • Medicare HMO: Wisconsin and Ohio
  • Humana Health Plan of Ohio, Inc. – Commercial HMO/POS
  • Humana Employers Health Plan of Georgia, Inc. – Commercial HMO/POS, Medicare HMO
  • Humana Health Benefit Plan of Louisiana, Inc. – Commercial HMO/POS, Medicare HMO/POS
  • Humana Health Benefit Plan of South Carolina, Inc. (also known as Humana Healthy Horizons in South Carolina) – Medicaid HMO
  • Cariten Health Plan, Inc. (Tennessee) – Medicare HMO
  • CHA HMO Inc. (Arizona, Colorado, Kansas, Missouri, Texas) – Medicare HMO
  • Humana Benefit Plan of Illinois, Inc. – Medicare HMO
  • Arcadian Health Plan, Inc. (Kentucky) – Medicare HMO
  • Independent Care Health Plan (also known as iCare, Wisconsin) – Medicaid HMO
• Multicultural Health Care Distinction
  • Humana Medical Plan, Inc. (Florida) – Medicaid HMO
  • Humana Health Plan, Inc. (Kentucky) – Medicaid HMO
• Long-term Services and Supports Distinction
  • Humana Medical Plan, Inc. (Florida) – Medicaid HMO
• Health Equity Accreditation
  • Independent Care Health Plan (also known as iCare, Wisconsin) – Medicaid HMO
  • Humana Health Benefit Plan of South Carolina, Inc. (also known as Humana Health Horizons in South Carolina) – Medicaid HMO
• Wellness and Health Promotion Accreditation
  • Go365, LLC.
• Accreditations in Planning Stages, Not Yet Accredited
  • Humana Wisconsin Health Organization Insurance Corporation (also known as Humana Healthy Horizons in Oklahoma) – Medicaid HMO (anticipated accreditation in September 2025)
  • Humana Health Plan of Ohio, Inc. (also known as Humana Healthy Horizons in Ohio) – Medicaid HMO (anticipated accreditation in July 2024)
  • Humana Health Benefit Plan of Louisiana, Inc. (also known as Humana Healthy Horizons in Louisiana) – Medicaid HMO (anticipated accreditation in June 2024)
  • Humana Health Plan of Michigan, Inc. – Medicare HMO (anticipated accreditation in June 2024)