Welcome to Humana Gold Plus Integrated!
What to expect when you first join a health plan
If you are newly enrolled in the Humana Gold Plus Integrated plan, you have a 180-day transition period during which you may maintain a current course of treatment with a provider who is currently out of the Humana Gold Plus Integrated network.
If you are transferring to the Humana Gold Plus Integrated plan from an existing plan, you have a 90-day transition period during which you may maintain a current course of treatment with a provider who is currently out of the Humana Gold Plus Integrated network.
If you are in a nursing facility when your enrollment in Humana Gold Plus Integrated begins, you may remain in the facility as long as you continue to meet the criteria for nursing facility care, unless you or your family prefers you move to a different nursing facility or return to the community. Nursing facility continued stay criteria is established by the state of Illinois.
After your transition period ends, you will need to see doctors and other providers in the Humana Gold Plus Integrated plan network. An in-network provider is a provider who works with the health plan. Learn more about the differences between in-network and out-of-network providers, and/or refer to Chapter 3, Section B, page 26 of your Member Handbook for more information on getting care.
When you become a member with Humana Gold Plus Integrated, you may need help with your medications. We want to make your enrollment or transition into our plan as easy as possible.
- During your first 90 days of enrollment, you will have access to at least one 30-day supply of the Part D drugs you currently take.
- During your first 180 days of enrollment, you will have access to the Medicaid-covered drugs you currently take:
- If you take a drug that is not on our list of covered drugs
- If health plan rules do not let you get the amount ordered by your doctor
- If the drug requires prior approval by Humana Gold Plus Integrated
If you live in a Long-Term Care Facility, we will cover a supply of your drug during the first 90 days of your enrollment in the plan, until we have given you a 91-98 day supply consistent with the dispensing increment, or less if your prescription is written for fewer days.
Please call us at 1-800-787-3311 (TTY: 711), Monday – Friday, 8 a.m. – 8 p.m., Central time, if you have questions, or to use our free interpreter services to answer questions about your health and drug plans.
Within the first 60 days of enrollment you will receive a health risk screening assessment.
Humana takes a personalized, accessible, and patient-centered approach to care using information we get by you completing a Health Risk Screening (HRS). The HRS helps us understand your healthcare needs. You have three options for completing your HRS:
- We will call you to complete the HRS.
- We will send you an HRS to complete at home, if we can’t reach you by phone.
- We can visit you in your home and complete the HRS with you in person, if you want.
When we send you an HRS, we also will send you a postage-paid return envelope for you to use to return the form to us. If you want help completing the form, we can call you or meet face-to-face.
For help, call Customer Service at 1-800-559-3917 (TTY: 711), Monday – Friday, 8 a.m. – 5 p.m., Central Time, and choose option 4. However, please note that our automated phone system may answer your call after-hours, during weekends, and on holidays. Please leave your name and telephone number, and we’ll call you back by the end of the next business day.