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.

About CORE certification

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

For more information about CORE, visit caqh.org opens in new window

About NCQA accreditation

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.

NCQA accredited entities

• Health Plan Accreditation
  • Humana Insurance Company (Arizona, Illinois, Kansas, Kentucky, Missouri, Ohio, Tennessee, Texas, Utah, Wisconsin) – Medicare PPO
  • Humana Medical Plan, Inc. (Florida) – Medicare HMO
  • Humana Medical Plan, Inc. (also known as Humana Healthy Horizons in Florida) – Medicaid HMO
  • Humana Health Plan, Inc. (also known as Humana Healthy Horizons in Kentucky) – Medicaid HMO
  • Humana Wisconsin Health Organization Insurance Corporation (Wisconsin, Ohio) – Medicare HMO
  • Humana Wisconsin Health Organization Insurance Corporation (also known as Humana Healthy Horizons in Oklahoma) – Medicaid HMO
  • Humana Health Plan of Ohio, Inc. (also known as Humana Healthy Horizons in Ohio) – Medicaid HMO
  • Humana Employers Health Plan of Georgia, Inc. – Medicare HMO
  • Humana Health Benefit Plan of Louisiana, Inc. – Medicare HMO
  • Humana Health Benefit Plan of Louisiana, Inc. (also known as Humana Healthy Horizons in Louisiana) – Medicaid HMO
  • 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
  • Humana Medical Plan of Michigan, Inc. – Medicare HMO
• Long-term Services and Supports Distinction
  • Humana Medical Plan, Inc. (also known as Humana Healthy Horizons in Florida) – Medicaid HMO
• Health Outcomes Accreditation
  • Independent Care Health Plan (also known as iCare, Wisconsin) – Medicaid HMO
  • Humana Health Benefit Plan of South Carolina, Inc. (also known as Humana Healthy Horizons in South Carolina) – Medicaid HMO 
  • Humana Health Benefit Plan of Louisiana, Inc. (also known as Humana Healthy Horizons in Louisiana) – Medicaid HMO
  • Humana Health Plan of Ohio, Inc. (also known as Humana Healthy Horizons in Ohio) – Medicaid HMO
  • Humana Medical Plan, Inc. (also known as Humana Healthy Horizons in Florida) – Medicaid HMO
  • Humana Health Plan, Inc. (also known as Humana Healthy Horizons in Kentucky) – Medicaid HMO
  • Humana Wisconsin Health Organization Insurance Corporation (also known as Humana Healthy Horizons in Oklahoma) – Medicaid HMO
• Accreditations in Planning Stages, Not Yet Accredited
  • Health Plan Accreditation
    • Arcadian Health Plan, Inc. (also known as Humana Healthy Horizons in Indiana – Indiana PathWays for Aging) – Medicaid HMO (anticipated accreditation in November 2026)
    • Humana Wisconsin Health Organization Insurance Corporation (also known as Humana, serving the Cardinal Care Managed Care Contract (CCMC), Virginia) – Medicaid HMO (anticipated accreditation in December 2026)
    • Careplus Health Plans, Inc. – Medicare HMO (anticipated accreditation in September 2027)
    • Humana Medical Plan of Michigan, Inc. – Medicaid HMO (anticipated accreditation in December 2027)
    • Humana Benefit Plan of Illinois, Inc. (also known as Humana Gold Plus^® Integrated Medicare-Medicaid) – Medicaid HMO (anticipated accreditation in December 2027)
  • Health Outcomes Accreditation 
    • Humana Benefit Plan of Illinois, Inc. (also known as Humana Gold Plus^® Integrated Medicare-Medicaid) – Medicaid HMO (anticipated accreditation in June 2027)
    • Humana Wisconsin Health Organization Insurance Corporation (also known as Humana, serving the Cardinal Care Managed Care Contract (CCMC), Virginia) – Medicaid HMO (anticipated accreditation in June 2027)
    • Arcadian Health Plan, Inc. (also known as Humana Healthy Horizons in Indiana – Indiana PathWays for Aging) – Medicaid HMO (anticipated accreditation in September 2027)
    • Humana Medical Plan of Michigan, Inc. – Medicaid HMO (anticipated accreditation in September 2027)