The following privacy practices have been updated effective May 2023:

  • HIPAA Privacy Notice: Applies to all entities that are part of the Insurance ACE, an Affiliated Covered Entity under HIPAA. The ACE is a group of legally separate covered entities that are affiliated and have designated themselves as a single covered entity for purposes of HIPAA.
  • State notices: Review notices specific to your state.
  • HIPAA Individual privacy rights: Get details on your privacy rights and download forms to exercise your rights.
HIPAA Privacy Notice State notices HIPAA Individual privacy rights

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

New York: Confidentiality for Domestic Violence Victims & Endangered Individuals Notice - English, PDF

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

Consent for release of protected health information - Spanish, PDF

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

Revocation of consent for release of protected health information - Spanish, PDF

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

Request for accounting of disclosures - Spanish , PDF

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

Request amendment of your protected health information - Spanish, PDF

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

Request to access protected health information - English, PDF

Request to access protected health information - Spanish, PDF

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

Request for restriction of protected health information - Spanish, PDF

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

Request for restriction termination - English, PDF

Request for restriction termination - Spanish, PDF

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

Request for alternate communications - Spanish, PDF

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

HIPPA privacy complaint form - Spanish, PDF