Privacy practices

View our privacy and financial practices

Notice of privacy practices – English pdf opens in new window

Notice of privacy practices – Spanish pdf opens in new window

Insurance Ace List pdf opens in new window

Humana has worked throughout the company to ensure compliance with privacy provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), a federal law designed to ensure the privacy of personal and health information.

Humana also complies with all state privacy laws, rules, and regulations. In addition to reviewing the Notice of Privacy Practices, residents of the following states should review the policies specific to those states.

California: No cost language translation - English pdf opens in new window

New York: Confidentiality for Domestic Violence Victims & Endangered Individuals Notice - English pdf opens in new window

Individual rights forms

This form grants Humana and its subsidiaries permission to share your information to a trusted individual(s) that you choose. The form below allows you to choose the level of information to share with the trusted individual. You can specify any and all information, information specific to a treatment or injury, or something different.

Consent for release of protected health information - English pdf opens in new window

Consent for release of protected health information - Spanish pdf opens in new window

This form terminates previously granted permission for Humana to release or disclose a member's protected health information to other individuals named on the form.

Revocation of consent for release of protected health information - English pdf opens in new window

Revocation of consent for release of protected health information - Spanish pdf opens in new window

This form requests a list of disclosures Humana made of a member's protected health information. Disclosures made for payment and health plan operations are excluded from this process.

Request for accounting of disclosures - English pdf opens in new window

Request for accounting of disclosures - Spanish pdf opens in new window

This form requests a correction to Humana-created protected health information that a member feels is inaccurate or incomplete.

Request amendment of your protected health information - English pdf opens in new window

Request amendment of your protected health information - Spanish pdf opens in new window

This form requests an inspection or copy of Humana-maintained protected health information about a member.

Request to access protected health information - English pdf opens in new window

Request to access protected health information - Spanish pdf opens in new window

This form requests limitation or restriction of disclosures of a member's protected health information to others such as a family member, friend, spouse, doctor, or any other party.

Request for restriction of protected health information - English pdf opens in new window

Request for restriction of protected health information - Spanish pdf opens in new window

This form withdraws a previously requested restriction of a member's protected health information.

Request for restriction termination - English pdf opens in new window

Request for restriction termination - Spanish pdf opens in new window

This form requests that Humana communicate with a member about protected health information in a different way during life-threatening situations. Examples of alternate means could include telephone, mail, e-mail, or a different address.

Request for alternate communications - English pdf opens in new window

Request for alternate communications - Spanish pdf opens in new window

This form documents an issue or concern if a member believes his or her privacy rights may have been violated.

HIPAA privacy complaint form - English pdf opens in new window

HIPPA privacy complaint form - Spanish pdf opens in new window