Member Forms

Forms made easy

Find all the forms you need listed right here.

Medical Forms

Health Benefits Claim Form (200 Kb)

Pharmacy Forms

Medicare Prescription Drug Claim Form (575 Kb)

Prescription Drug Claim Form (200 Kb)

LINET Prescription Drug Claim Form - English (135 Kb)

Prescription Drug Claim Form- Spanish (322 Kb)

LINET Prescription Drug Claim Form - Spanish (288 Kb)

General form used to submit pharmacy benefits claims.

Grievance and Appeals Request Forms
Individual & Family Plan Members

You also can get the Appointment of Representative form on CMS's website (link opens in new window) .

Provider Reconsideration Waiver (71.73 Kb)

UMB Health Savings Account Forms

RightSource Mail Order Pharmacy Forms

Michelle's Law

Federal HR 2851 "Michelle's Law" (32 Kb)

Process for continued coverage for full time students who are on medical leave of absence.

Financial Protection Products (FPP) Claim Forms

Financial Protection Products (FPP) Service Forms


Website Blocking (53 Kb)

Disable the secure member Website for yourself or a family member.


View Humana's privacy rights and download forms, including:

View all medical forms