This material is provided for informational use only and should not be construed as medical advice or used in place of consulting a licensed medical professional. You should consult with your doctor to determine what is right for you.
The right care, when you need it
With your Humana health plan, you have access to healthcare services at doctors, retail clinics, urgent care centers and hospitals in your plan’s network. Seeing these network providers may save you time and money when you need care. Here are some places you can go, depending on the care you need:
Your primary care doctor is always your first choice, unless it’s an emergency. In fact, visiting your doctor for a preventive care checkup, covered by most plans at no extra cost, gives your doctor a chance to get to know you so he or she can be a true partner in helping you achieve lifelong well-being.
You can often find retail clinics in supermarkets or drug stores. They are usually open the same hours as the store. You usually don't need an appointment for low-cost treatment of minor problems. Check your provider directory to see which retail clinics are available in your plan’s network.
Urgent care center
An urgent care center or retail clinic is a great choice if your doctor isn’t available and you need care right away for something like the flu, infections, minor burns or sprains. You don’t need to schedule an appointment, and most are open evenings and weekends. If your doctor's office is closed, an urgent care center is a good choice because:
- They usually don't require appointments
- They are open later than most doctors' offices
- They provide faster care at a price lower than most hospital emergency rooms.
Check your provider directory to see which urgent care centers are available in your plan’s network.
When you have a life-threatening injury or condition, always go to the emergency room – preferably at a network hospital – or call 911. If you think you have a serious medical problem—like a stroke or heart attack—please play it safe. Get emergency care right away if you have any of these concerns:
- Chest pain
- Trouble breathing
- Bleeding or vomiting that won't stop
- Major burns, cuts, or breaks
- Loss of consciousness
- Signs or symptoms of a stroke
- Any threat to life or limb
These are just examples of situations that require Emergency Room treatment. More information is available at this link: Emergency Care Information.
Your plan covers true emergencies at in-network and out-of-network providers, and no referrals or prior authorizations are needed.
You can search "Hospital" under Humana's online “Find a Doctor” search tool to find a hospital emergency room in your Humana network. Then put the information where it's easy to find. You may want to put it by your phone or refrigerator. That way, if you do have a medical emergency, you may still be able to use a facility in your plan’s network and save money.
HumanaFirst Nurse Advice Line
If you're not sure where to get medical care, call the HumanaFirst® Nurse Advice Line. You can call anytime, 24 hours a day, at 1-800-622-9529. If you get your Humana insurance through your employer, ask your employer if this service is part of your plan.
Outpatient care centers and surgery centers
Outpatient care centers can take care of many services, including some tests and surgery. Places that handle surgery outside of a hospital are called "surgery centers." If your doctor wants you to have tests or surgery, ask whether you can go to an outpatient care or surgery center. They can be easier to use, and they can cost less than going to a hospital. Check your provider directory to see which outpatient care and surgery centers are available in your plan’s network.
Care in the hospital
You may have to stay in the hospital for some medical problems. Hospital care is usually very expensive, and you may have other options in some cases. Talk with your doctor before you make any decisions about hospital care. Ask your doctor if you can use an outpatient center or urgent care center instead of going into a hospital. If you do need to stay in a hospital, be sure to choose a hospital in your plan's network.
Care away from home
When you're traveling, you can save money by using providers in your Humana network. When you're away from home, call the number on your Humana ID card to find an in-network provider. Or, before you go, log in to your personal account on Humana.com and use the "Find a Doctor” search tool to look for doctors and hospitals in the area you're going to visit. Your health plan may not let you use providers who are not in your plan's service area. See your coverage details, or call Member Service for specific details about your plan.
If you need emergency care while traveling, go to the nearest emergency room. Your plan covers true emergencies at in-network and out-of-network providers.
If you are traveling and become ill, call Member Service to see if your plan offers an in-network urgent care center or retail clinic in that area.