Humana Healthy Horizons in Florida Expanded benefits

Adult Additional Primary Care Services

Non-pregnant adult members Age 21 and older, unlimited primary care provider visits

You pay nothing

Adult Visual Aid Services

Adult members Age 21 and older, the plan covers

1 eye exam a year and one of the following:

• 1 set of frames a year,
• Member pays any cost over $75 for luxury frames
• A 6-month supply of contact lenses with a doctor’s prescription

You pay nothing unless you select luxury frames that cost over $75

Baby and Me Meals

Up to 2 pre-cooked home-delivered meals per day for 10 weeks for pregnant women who are high risk.

You pay nothing

Convertible Car Seat or Portable Crib

Pregnant members who enroll and actively participate in our HumanaBeginnings Care Management program and complete a comprehensive assessment and at least 1 follow-up call with a HumanaBeginnings Care Manager can select 1 convertible car seat or portable crib per infant, per pregnancy.

You pay nothing

Criminal Expungement Services

Members ages 18 and older can receive reimbursement of up to $75 for criminal record expungement, as allowed per www.fdle.state.fl.us/Seal-and-Expunge-Process, per lifetime.

You will be refunded

Day Trip - Meal Reimbursement/ Allowance

Adult members Age 21 and older, up to $1000 a year ($200 daily limit) for same-day medical trips more than 100 miles from home

You will be refunded

Disaster Preparedness Meals

1 box of 14 shelf-stable meals before or after a natural disaster, twice annually.

• Member must not live in a residential or nursing facility
• The Governor must declare the disaster for the member to be eligible for the meals

You pay nothing

Doula Services

Doula assistance to provide emotional and physical support to the laboring mother and her family:

•  5 Prenatal visits
• 1 Birth coaching assistance during vaginal delivery
• 3 Postpartum visits         

You pay nothing

Durable Medical Equipment Services and Supplies

Adult members Age 21 and older that are under care management with blood pressure monitoring included in their care plan, may receive 1 digital blood pressure cuff every 3 years.

You pay nothing

Expanded Prenatal/ Perinatal Services

For members Age 10-59, the plan covers:

• 14 prenatal visits for low-risk pregnancies and 18 prenatal visits for high-risk pregnancies.
• 3 postpartum visits within 90 days following delivery
• 1 well-woman visit between 90 days and 12 months following delivery in preparation to transition the member back to their primary care medical home
• Non-hospital grade breast pump - 1 per 2 years, rental
• Hospital grade breast pump - 1 rental per year

You pay nothing

Financial Literacy Coaching

Members Age 16 and older:

Up to 6 life coaching sessions for money management/ budgeting.

You pay nothing

GED Testing

For members Age 16 and older GED test preparation assistance, including a bilingual advisor, access to guidance and study materials, and unlimited use of practice tests. Test preparation assistance, including tutoring, is provided virtually to allow maximum flexibility for members. Also includes test pass guarantee to provide members multiple attempts at passing the test.

You pay nothing

Hearing Services for Adults

You are covered for medically necessary hearing screenings and diagnostic testing.

Adult members Age 21 and older, the plan covers:

• 1 hearing aid assessment, fitting, checking, and evaluation every 2 years
• 1 in ear monaural hearing aid per ear each year
• 1 hearing aid, all other types, per ear every 2 years

Call Hear USA at 877-664-9353 for a hearing provider near you.

You pay nothing

Home Delivered Meals

Adult members Age 18 and older, 14 meals delivered to your home once per year

You pay nothing

Home-Based Asthma Interventions

Adult asthmatic members Age 21 and older, in our Care Management or Disease Management programs can receive reimbursement up to $250 per year for allergen free bedding and/or an air purifier

You will be refunded

Hospital Services – Outpatient

Adult members Age 21 and older, no dollar limit on services

You pay nothing

Housing Assistance

Adult members Age 18 and older up to $500 per household per year (unused allowance does not roll over to the next year) to assist with the following housing expenses:

• Apartment rent or mortgage payment (late payment notice required)
• Utility payment for electric, water, gas or internet (late payment notice required)
• Trailer Park and lot rent if this is your permanent residence (late payment notice required)
• Moving expenses via licensed moving company when transitioning from a public housing authority

Requirements:

• Member must not live in a residential facility or nursing facility
• Funds will not be paid directly to the member
• If the bill is in the spouse’s name, a marriage certificate may be submitted as proof

You pay nothing

Housing Supports

Families of children up to Age 21, in a nursing facility preparing to transition their child home may receive up to $50,000 per lifetime for home readiness projects, such as physical adaptations to their home or vehicle.

You pay nothing

Humana Tranquility Goods

Members can qualify through the following event/diagnosis: Children/Adolescents with an emotional and/or behavioral diagnosis, such as Acute Stress Disorder, Disinhibited Social Engagement Disorder, Adjustment Disorder, Unclassified and Unspecified Trauma Disorder, Reactive Attachment Disorder, and/or PTSD

You pay nothing

Maternal and Infant Virtual Care

Pregnant members and members with a child up to 1 year of age, unlimited access to a smartphone application that provides 24 hour a day, 7 days a week access to a proprietary, video-enabled call routing system that allows members to connect with a lactation consultant or a physician extender for on-demand assistance.

You pay nothing

Newborn Circumcision

Your male baby is covered, 1 per lifetime for members Age 0 to 28 days old

You pay nothing.

Non Medical Transportation (NMT) for Behavioral Health Parent/Guardian

For members Age 18 and under, 4 in-state round trips (8 in-state one-way trips) per month for a member’s parent and/or guardian to visit the member while in a behavioral health residential setting or a statewide inpatient psychiatric program (SIPP). Excludes members’ parents and guardians that have their own means of transportation.

You pay nothing

Non Medical Transportation (NMT) Social Needs

Adult members Age 18 and older up to 6 round trips (12 one-way trips) up to 30 miles for non-medical transportation per year to locations such as social support groups, wellness classes, WIC and SNAP appointments, and food banks. This benefit also offers transportation to locations providing social benefits and community integration for members such as community and neighborhood centers, parks, recreation areas, and churches.

You pay nothing

Nutrition Shakes

Members living with HIV deemed malnourished by their provider and unable to prepare meals, may receive a package of 21 nutritional shakes twice per year.

You pay nothing

Occupational Therapy for Adults

Adult members Age 21 and older are covered for:

• 1 evaluation/re-evaluation per year
• Up to 7 therapy units per week
• Application of casting or strapping - Members who have been evaluated by an occupational therapist may receive a maximum of 3 casting or strapping services a week per their treatment plan.  Services must be clinically indicated; evidence based; and not experimental.  
• Wheelchair evaluation and fitting by an occupational therapist - If a member has a change in their medical condition, they may receive up to 5 wheelchair evaluations and/or fittings by an occupational therapist every 5 years

You pay nothing

Over-the- Counter (OTC) Medications and Supplies

$50 per month allowance enables households to purchase products that support common occurring conditions such as:

• Pain relievers 
• Diaper rash cream
• Cough and cold relief medicine
• First aid equipment that do not require prescriptions.

Unused amounts do not roll over to the next month.

You pay nothing

Pathway Licensure and/or Certification

Pathway members Age 16 and older who are participating in Humana’s workforce management program may receive financial assistance with covering the cost of professional licensure and/or certification for the following professions:

• Licensed practical nurse - up to $105 (Department of Health)
• Barber - up to$155 (Department of Business and Professional Regulation)
• Cosmetology - up to $55 - (Department of Business and Professional Regulation)
• Child care home license - up to $75 (Department of Children & Families)

Member must submit evidence they completed the education and/or training required by profession.

Allowance is limited to once per year.

You pay nothing

Physical Therapy for Adults

Adult members Age 21 and older are covered for:

• 1 evaluation/re-evaluation per year
• Up to 7 therapy units per week
• Application of casting or strapping - Members who have been evaluated by a physical therapist may receive a maximum of 3 casting or strapping services a week per their treatment plan.  Services must be clinically indicated; evidence based; and not experimental.  
• Wheelchair evaluation and fitting by a physical therapist - If a member has a change in their medical condition, they may receive up to 5 wheelchair evaluations and/or fittings by a physical therapist every 5 years

You pay nothing

Post Discharge Meal

14 refrigerated home-delivered meals following discharge from an inpatient or residential facility. No limit on the number of discharges per year.

You pay nothing.

Respiratory Therapy for Adults

Adult members Age 21 and older are covered for:

• 1 evaluation/re-evaluation per year and
• 1 therapy treatment per day

You pay nothing

Respite Services for Enrollees on HBCS Waiver Waiting List

Members with a caregiver who are on a waiver waiting list for home and community-based services (HCBS) may be eligible for up to 60 hours of respite services per year

Member must not live in a residential or nursing facility

You pay nothing

Respite Services for Medically Complex Children

Members ages 20 and under, may be eligible for up to 240 hours of respite services per year to afford temporary relief to family caregivers.

Respite care services are provided on a short-term basis as a temporary support to the recipient’s family. It may be provided in the absence of or for relief of the recipient’s family. Respite care may be used to meet a range of recipient needs. These include:

• Family emergencies.
• Planned absences, such as vacations, hospitalizations, or business trips.
• Relief from the stresses of caregiving; and
• Giving the child respite from his family.

Respite care may be provided in the recipient’s home, place of residence or a Nursing Facility.

Members must first exhaust services covered through HCBS Waivers they are enrolled on.

You pay nothing

Return to Home Meals for Families of Nursing Facility Children

Home-delivered meals for family members of nursing facility members, up to age 30 if they began living in a nursing facility before reaching 21 years of age, when transitioning to the home. Members may receive up to 2 meals per day for 1 week.

Family members must primarily reside in the member’s home.

You pay nothing

Smartphone Service

Smartphones can provide easy access to health related information and enable members to stay connected to their care team and health plan. Humana members that qualify for the Federal Lifeline program are eligible to receive a free smartphone with monthly talk minutes, text and data.

You pay nothing.

Sports Physical

1 sports physical per year for members Age 6 to 18

You pay nothing

Swimming Lessons

Members up to Age 21 are covered for swimming lessons up to $200 a year. This is limited to 1000 enrollees per year.

You will be refunded

Transition Assistance Deposit for Nursing Facility Children

Members, up to age 30 if they began living in a nursing facility before reaching 21 years of age, may be eligible to receive up to $1,500 per lifetime to assist with identifying, coordinating, securing, or funding one-time services and modifications necessary to enable a person to establish a basic household that do not constitute room and board.

• Security deposits required to obtain a lease on an apartment or home.
• Coverage for utilities including set up fees or deposits, first month coverage, or back payments.
• First months and last month’s rent as required by landlord for occupancy or housing maintenance.
• Services necessary for the individual’s health and safety, such as pest eradication
• Services must be identified as reasonable and necessary in the members individualized housing. Members must first exhaust services covered through HCBS Waivers they are enrolled on.

You pay nothing

Virtual Exercise Classes

Members living with HIV can access virtual fitness classes including over 1,000 on-demand classes across multiple exercise modalities including high-intensity interval training (HIIT), core-strength, cycling, yoga, and other specialty fitness classes. Classes will be offered in a wide variety of intensities and class lengths (from 5 minutes to 60 minutes) to help members achieve their health and wellness goals. The digital fitness content will include adaptive workouts and classes suitable for those with chronic conditions and mobility challenges. This virtual offering will improve accessibility of exercise programming and address barriers (transportation, mobility, etc.) that may prevent members from engaging in in-person fitness.

You pay nothing

Waived copayments

No copays on any services

Youth Academic Support

Access to online tutoring services up to 2 hours per week as well as ACT/SAT test preparation for members in grades K-12 (ages 5-19).

You pay nothing

Adult Additional Primary Care Services

Non-pregnant adult members Age 21 and older, unlimited primary care provider visits

You pay nothing

Adult Visual Aid Services

Adult members Age 21 and older, the plan covers

• 1 eye exam a year and one of the following:
  • 1 set of frames a year,
  • Member pays any cost over $75 for luxury frames
  • A 6-month supply of contact lenses with a doctor’s prescription

You pay nothing unless you select luxury frames that cost over $75

Baby and Me Meals

Up to 2 pre-cooked home-delivered meals per day for 10 weeks for pregnant women who are high risk.

You pay nothing

Convertible Car Seat or Portable Crib

Pregnant members who enroll and actively participate in our HumanaBeginnings Care Management program and complete a comprehensive assessment and at least 1 follow-up call with a HumanaBeginnings Care Manager can select 1 convertible car seat or portable crib per infant, per pregnancy.

You pay nothing

Criminal Expungement Services

Members ages 18 and older can receive reimbursement of up to $75 for criminal record expungement, as allowed per www.fdle.state.fl.us/Seal-and-Expunge-Process, per lifetime.

You will be refunded

Day Trip - Meal Reimbursement/ Allowance

Adult members Age 21 and older, up to $1000 a year ($200 daily limit) for same-day medical trips more than 100 miles from home

You will be refunded

Disaster Preparedness Meals

1 box of 14 shelf-stable meals before or after a natural disaster, twice annually.

• Member must not live in a residential or nursing facility
• The Governor must declare the disaster for the member to be eligible for the meals

You pay nothing

Doula Services

Doula assistance to provide emotional and physical support to the laboring mother and her family:

• 5 Prenatal visits
• 1 Birth coaching assistance during vaginal delivery
• 3 Postpartum visits       

You pay nothing

Durable Medical Equipment Services and Supplies

Adult members Age 21 and older that are under care management with blood pressure monitoring included in their care plan, may receive 1 digital blood pressure cuff every 3 years.

You pay nothing

Expanded Prenatal/ Perinatal Services

For members Age 10-59, the plan covers:

• 14 prenatal visits for low-risk pregnancies and 18 prenatal visits for high-risk pregnancies.
• 3 postpartum visits within 90 days following delivery
• 1 well-woman visit between 90 days and 12 months following delivery in preparation to transition the member back to their primary care medical home
• Non-hospital grade breast pump - 1 per 2 years, rental
• Hospital grade breast pump - 1 rental per year

You pay nothing

Financial Literacy Coaching

Members Age 16 and older:

Up to 6 life coaching sessions for money management/ budgeting.

You pay nothing

GED Testing

For members Age 16 and older GED test preparation assistance, including a bilingual advisor, access to guidance and study materials, and unlimited use of practice tests. Test preparation assistance, including tutoring, is provided virtually to allow maximum flexibility for members. Also includes test pass guarantee to provide members multiple attempts at passing the test.

You pay nothing

Hearing Services for Adults

You are covered for medically necessary hearing screenings and diagnostic testing.

Adult members Age 21 and older, the plan covers:

• 1 hearing aid assessment, fitting, checking, and evaluation every 2 years
• 1 in ear monaural hearing aid per ear each year
• 1 hearing aid, all other types, per ear every 2 years

Call Hear USA at 877-664-9353 for a hearing provider near you.

You pay nothing

Home Delivered Meals

Adult members Age 18 and older, 14 meals delivered to your home once per year

You pay nothing

Home-Based Asthma Interventions

Adult asthmatic members Age 21 and older, in our Care Management or Disease Management programs can receive reimbursement up to $250 per year for allergen free bedding and/or an air purifier

You will be refunded

Hospital Services – Outpatient

Adult members Age 21 and older, no dollar limit on services

You pay nothing

Housing Assistance

Adult members Age 18 and older up to $500 per household per year (unused allowance does not roll over to the next year) to assist with the following housing expenses:

• Apartment rent or mortgage payment (late payment notice required)
• Utility payment for electric, water, gas or internet (late payment notice required)
• Trailer Park and lot rent if this is your permanent residence (late payment notice required)
• Moving expenses via licensed moving company when transitioning from a public housing authority

Requirements:

• Member must not live in a residential facility or nursing facility
• Funds will not be paid directly to the member
• If the bill is in the spouse’s name, a marriage certificate may be submitted as proof

You pay nothing

Housing Supports

Families of children up to Age 21, in a nursing facility preparing to transition their child home may receive up to $50,000 per lifetime for home readiness projects, such as physical adaptations to their home or vehicle.

You pay nothing

Humana Tranquility Goods

Members Age 6 to 18 can receive supplies to calm the impact of trauma including a sound machine, light therapy products, or weighted pillow/blankets. Once per year.

Members can qualify through the following event/diagnosis: Children/Adolescents with an emotional and/or behavioral diagnosis, such as Acute Stress Disorder, Disinhibited Social Engagement Disorder, Adjustment Disorder, Unclassified and Unspecified Trauma Disorder, Reactive Attachment Disorder, and/or PTSD

You pay nothing

Maternal and Infant Virtual Care

Pregnant members and members with a child up to 1 year of age, unlimited access to a smartphone application that provides 24 hour a day, 7 days a week access to a proprietary, video-enabled call routing system that allows members to connect with a lactation consultant or a physician extender for on-demand assistance.

You pay nothing

Newborn Circumcision

Your male baby is covered, 1 per lifetime for members Age 0 to 28 days old

You pay nothing.

Non Medical Transportation (NMT) for Behavioral Health Parent/Guardian

For members Age 18 and under, 4 in-state round trips (8 in-state one-way trips) per month for a member’s parent and/or guardian to visit the member while in a behavioral health residential setting or a statewide inpatient psychiatric program (SIPP). Excludes members’ parents and guardians that have their own means of transportation.

You pay nothing

Non Medical Transportation (NMT) Social Needs

Adult members Age 18 and older up to 6 round trips (12 one-way trips) up to 30 miles for non-medical transportation per year to locations such as social support groups, wellness classes, WIC and SNAP appointments, and food banks. This benefit also offers transportation to locations providing social benefits and community integration for members such as community and neighborhood centers, parks, recreation areas, and churches.

You pay nothing

Nutrition Shakes

Members living with HIV deemed malnourished by their provider and unable to prepare meals, may receive a package of 21 nutritional shakes twice per year.

You pay nothing

Occupational Therapy for Adults

Adult members Age 21 and older are covered for:

• 1 evaluation/re-evaluation per year
• Up to 7 therapy units per week
• Application of casting or strapping - Members who have been evaluated by an occupational therapist may receive a maximum of 3 casting or strapping services a week per their treatment plan.  Services must be clinically indicated; evidence based; and not experimental.  
• Wheelchair evaluation and fitting by an occupational therapist - If a member has a change in their medical condition, they may receive up to 5 wheelchair evaluations and/or fittings by an occupational therapist every 5 years

You pay nothing

Over-the- Counter (OTC) Medications and Supplies

$50 per month allowance enables households to purchase products that support common occurring conditions such as:

• Pain relievers 
• Diaper rash cream
• Cough and cold relief medicine
• First aid equipment that do not require prescriptions.
• Unused amounts do not roll over to the next month.

You pay nothing

Pathway Licensure and/or Certification

Pathway members Age 16 and older who are participating in Humana’s workforce management program may receive financial assistance with covering the cost of professional licensure and/or certification for the following professions:

• Licensed practical nurse - up to $105 (Department of Health)
• Barber - up to$155 (Department of Business and Professional Regulation)
• Cosmetology - up to $55 - (Department of Business and Professional Regulation)
• Child care home license - up to $75 (Department of Children & Families)

Member must submit evidence they completed the education and/or training required by profession.

Allowance is limited to once per year.

You pay nothing

Physical Therapy for Adults

Adult members Age 21 and older are covered for:

• 1 evaluation/re-evaluation per year
• Up to 7 therapy units per week
• Application of casting or strapping - Members who have been evaluated by a physical therapist may receive a maximum of 3 casting or strapping services a week per their treatment plan.  Services must be clinically indicated; evidence based; and not experimental.  
• Wheelchair evaluation and fitting by a physical therapist - If a member has a change in their medical condition, they may receive up to 5 wheelchair evaluations and/or fittings by a physical therapist every 5 years

You pay nothing

Post Discharge Meal

14 refrigerated home-delivered meals following discharge from an inpatient or residential facility. No limit on the number of discharges per year.

You pay nothing

Respiratory Therapy for Adults

Adult members Age 21 and older are covered for:

• 1 evaluation/re-evaluation per year and
• 1 therapy treatment per day

You pay nothing

Smartphone Service

Smartphones can provide easy access to health related information and enable members to stay connected to their care team and health plan. Humana members that qualify for the Federal Lifeline program are eligible to receive a free smartphone with monthly talk minutes, text and data.

You pay nothing.

Sports Physical

1 sports physical per year for members Age 6 to 18

You pay nothing

Swimming Lessons

Members up to Age 21 are covered for swimming lessons up to $200 a year. This is limited to 1000 enrollees per year.

You will be refunded

Virtual Exercise Classes

Members living with HIV can access virtual fitness classes including over 1,000 on-demand classes across multiple exercise modalities including high-intensity interval training (HIIT), core-strength, cycling, yoga, and other specialty fitness classes. Classes will be offered in a wide variety of intensities and class lengths (from 5 minutes to 60 minutes) to help members achieve their health and wellness goals. The digital fitness content will include adaptive workouts and classes suitable for those with chronic conditions and mobility challenges. This virtual offering will improve accessibility of exercise programming and address barriers (transportation, mobility, etc.) that may prevent members from engaging in in-person fitness.

You pay nothing

Waived copayments

No copays on any services

Youth Academic Support

Access to online tutoring services up to 2 hours per week as well as ACT/SAT test preparation for members in grades K-12 (ages 5-19).

You pay nothing

Adult Additional Primary Care Services

Non-pregnant adult members Age 21 and older, unlimited primary care provider visits

You pay nothing

Adult Visual Aid Services

Adult members Age 21 and older, the plan covers

1 eye exam a year and one of the following:

• 1 set of frames a year,
• Member pays any cost over $75 for luxury frames
• A 6-month supply of contact lenses with a doctor’s prescription

You pay nothing unless you select luxury frames that cost over $75

Baby and Me Meals

Up to 2 pre-cooked home-delivered meals per day for 10 weeks for pregnant women who are high risk.

You pay nothing

Convertible Car Seat or Portable Crib

Pregnant members who enroll and actively participate in our HumanaBeginnings Care Management program and complete a comprehensive assessment and at least 1 follow-up call with a HumanaBeginnings Care Manager can select 1 convertible car seat or portable crib per infant, per pregnancy.

You pay nothing

Criminal Expungement Services

Members ages 18 and older can receive reimbursement of up to $75 for criminal record expungement, as allowed per www.fdle.state.fl.us/Seal-and-Expunge-Process, per lifetime.

You will be refunded

Day Trip - Meal Reimbursement/ Allowance

Adult members Age 21 and older, up to $1000 a year ($200 daily limit) for same-day medical trips more than 100 miles from home

You will be refunded

Disaster Preparedness Meals

1 box of 14 shelf-stable meals before or after a natural disaster, twice annually.

• Member must not live in a residential or nursing facility
• The Governor must declare the disaster for the member to be eligible for the meals

You pay nothing

Doula Services

Doula assistance to provide emotional and physical support to the laboring mother and her family:

• 5 Prenatal visits
• 1 Birth coaching assistance during vaginal delivery
• 3 Postpartum visits       

You pay nothing

Durable Medical Equipment Services and Supplies

Adult members Age 21 and older that are under care management with blood pressure monitoring included in their care plan, may receive 1 digital blood pressure cuff every 3 years.

You pay nothing

Expanded Prenatal/ Perinatal Services

For members Age 10-59, the plan covers:

• 14 prenatal visits for low-risk pregnancies and 18 prenatal visits for high-risk pregnancies.
• 3 postpartum visits within 90 days following delivery
• 1 well-woman visit between 90 days and 12 months following delivery in preparation to transition the member back to their primary care medical home
• Non-hospital grade breast pump - 1 per 2 years, rental
• Hospital grade breast pump - 1 rental per year

You pay nothing

Financial Literacy Coaching

Members Age 16 and older:

Up to 6 life coaching sessions for money management/ budgeting.

You pay nothing

GED Testing

For members Age 16 and older GED test preparation assistance, including a bilingual advisor, access to guidance and study materials, and unlimited use of practice tests. Test preparation assistance, including tutoring, is provided virtually to allow maximum flexibility for members. Also includes test pass guarantee to provide members multiple attempts at passing the test.

You pay nothing

Hearing Services for Adults

You are covered for medically necessary hearing screenings and diagnostic testing.

Adult members Age 21 and older, the plan covers:

• 1 hearing aid assessment, fitting, checking, and evaluation every 2 years
• 1 in ear monaural hearing aid per ear each year
• 1 hearing aid, all other types, per ear every 2 years

Call Hear USA at 877-664-9353 for a hearing provider near you.

You pay nothing

Home Delivered Meals

Adult members Age 18 and older, 14 meals delivered to your home once per year

You pay nothing

Home-Based Asthma Interventions

Adult asthmatic members Age 21 and older, in our Care Management or Disease Management programs can receive reimbursement up to $250 per year for allergen free bedding and/or an air purifier

You will be refunded

Hospital Services – Outpatient

Adult members Age 21 and older, no dollar limit on services

You pay nothing

Housing Assistance

Adult members Age 18 and older up to $500 per household per year (unused allowance does not roll over to the next year) to assist with the following housing expenses:

• Apartment rent or mortgage payment (late payment notice required)
• Utility payment for electric, water, gas or internet (late payment notice required)
• Trailer Park and lot rent if this is your permanent residence (late payment notice required)
• Moving expenses via licensed moving company when transitioning from a public housing authority

Requirements:

• Member must not live in a residential facility or nursing facility
• Funds will not be paid directly to the member
• If the bill is in the spouse’s name, a marriage certificate may be submitted as proof

You pay nothing

Housing Supports

Families of children up to Age 21, in a nursing facility preparing to transition their child home may receive up to $50,000 per lifetime for home readiness projects, such as physical adaptations to their home or vehicle.

You pay nothing

Humana Tranquility Goods

Members Age 6 to 18 can receive supplies to calm the impact of trauma including a sound machine, light therapy products, or weighted pillow/blankets. Once per year.

Members can qualify through the following event/diagnosis: Children/Adolescents with an emotional and/or behavioral diagnosis, such as Acute Stress Disorder, Disinhibited Social Engagement Disorder, Adjustment Disorder, Unclassified and Unspecified Trauma Disorder, Reactive Attachment Disorder, and/or PTSD

You pay nothing

Maternal and Infant Virtual Care

Pregnant members and members with a child up to 1 year of age, unlimited access to a smartphone application that provides 24 hour a day, 7 days a week access to a proprietary, video-enabled call routing system that allows members to connect with a lactation consultant or a physician extender for on-demand assistance.

You pay nothing

Newborn Circumcision

Your male baby is covered, 1 per lifetime for members Age 0 to 28 days old

You pay nothing.

Non Medical Transportation (NMT) for Behavioral Health Parent/Guardian

For members Age 18 and under, 4 in-state round trips (8 in-state one-way trips) per month for a member’s parent and/or guardian to visit the member while in a behavioral health residential setting or a statewide inpatient psychiatric program (SIPP). Excludes members’ parents and guardians that have their own means of transportation.

You pay nothing

Non Medical Transportation (NMT) Social Needs

Adult members Age 18 and older up to 6 round trips (12 one-way trips) up to 30 miles for non-medical transportation per year to locations such as social support groups, wellness classes, WIC and SNAP appointments, and food banks. This benefit also offers transportation to locations providing social benefits and community integration for members such as community and neighborhood centers, parks, recreation areas, and churches.

You pay nothing

Nutrition Shakes

Members living with HIV deemed malnourished by their provider and unable to prepare meals, may receive a package of 21 nutritional shakes twice per year.

You pay nothing

Occupational Therapy for Adults

Adult members Age 21 and older are covered for:

• 1 evaluation/re-evaluation per year
• Up to 7 therapy units per week
• Application of casting or strapping - Members who have been evaluated by an occupational therapist may receive a maximum of 3 casting or strapping services a week per their treatment plan.  Services must be clinically indicated; evidence based; and not experimental.  
• Wheelchair evaluation and fitting by an occupational therapist - If a member has a change in their medical condition, they may receive up to 5 wheelchair evaluations and/or fittings by an occupational therapist every 5 years

You pay nothing

Over-the- Counter (OTC) Medications and Supplies

$50 per month allowance enables households to purchase products that support common occurring conditions such as:

• Pain relievers 
• Diaper rash cream
• Cough and cold relief medicine
• First aid equipment that do not require prescriptions.

Unused amounts do not roll over to the next month.

You pay nothing

Pathway Licensure and/or Certification

Pathway members Age 16 and older who are participating in Humana’s workforce management program may receive financial assistance with covering the cost of professional licensure and/or certification for the following professions:

• Licensed practical nurse - up to $105 (Department of Health)
• Barber - up to$155 (Department of Business and Professional Regulation)
• Cosmetology - up to $55 - (Department of Business and Professional Regulation)
• Child care home license - up to $75 (Department of Children & Families)

Member must submit evidence they completed the education and/or training required by profession.

Allowance is limited to once per year.

You pay nothing

Physical Therapy for Adults

Adult members Age 21 and older are covered for:

• 1 evaluation/re-evaluation per year
• Up to 7 therapy units per week
• Application of casting or strapping - Members who have been evaluated by a physical therapist may receive a maximum of 3 casting or strapping services a week per their treatment plan.  Services must be clinically indicated; evidence based; and not experimental.  
• Wheelchair evaluation and fitting by a physical therapist - If a member has a change in their medical condition, they may receive up to 5 wheelchair evaluations and/or fittings by a physical therapist every 5 years

You pay nothing

Post Discharge Meal

14 refrigerated home-delivered meals following discharge from an inpatient or residential facility. No limit on the number of discharges per year.

You pay nothing

Respiratory Therapy for Adults

Adult members Age 21 and older are covered for:

• 1 evaluation/re-evaluation per year and
• 1 therapy treatment per day

You pay nothing

Smartphone Service

Smartphones can provide easy access to health related information and enable members to stay connected to their care team and health plan. Humana members that qualify for the Federal Lifeline program are eligible to receive a free smartphone with monthly talk minutes, text and data.

You pay nothing.

Sports Physical

1 sports physical per year for members Age 6 to 18

You pay nothing

Swimming Lessons

Members up to Age 21 are covered for swimming lessons up to $200 a year. This is limited to 1000 enrollees per year.

You will be refunded

Virtual Exercise Classes

Members living with HIV can access virtual fitness classes including over 1,000 on-demand classes across multiple exercise modalities including high-intensity interval training (HIIT), core-strength, cycling, yoga, and other specialty fitness classes. Classes will be offered in a wide variety of intensities and class lengths (from 5 minutes to 60 minutes) to help members achieve their health and wellness goals. The digital fitness content will include adaptive workouts and classes suitable for those with chronic conditions and mobility challenges. This virtual offering will improve accessibility of exercise programming and address barriers (transportation, mobility, etc.) that may prevent members from engaging in in-person fitness.

You pay nothing

Waived copayments

No copays on any services

Youth Academic Support

Access to online tutoring services up to 2 hours per week as well as ACT/SAT test preparation for members in grades K-12 (ages 5-19).

You pay nothing

Adult Visual Aid Services

You are covered for medically necessary services members Age 21 and older, the plan covers:

1 eye exam per year and one of the following:

• 1 set of frames per year; member pays any cost over $75 for luxury frames
• A 6-month supply of contact lenses with a doctor’s prescription

You pay nothing unless you select luxury frames that cost over $75n

Assisted Living Facility – Bed Hold Expansion

Members Age 18 and older, your bed will be saved for up to 30 days each time you leave an assisted living facility (ALF) or adult family care home (AFCH)

• You must plan to go back to the ALF/AFCH
• You must pay your room and board and share of payments when you are away
• You must live in the ALF/ AFCH for at least 30 days between each time you leave
• The ALF/AFCH must tell Humana you have left within 24 hours

You pay nothing

Assisted Living Facility - Move- In Basket

Members Age 18 and older and currently living in an assisted living facility (ALF) or those who transition/move into an ALF. Members can pick between two baskets:

• Basket 1: An insulated tumbler, rainbow medication tray, and plush Sherpa home throw blanket inside a clear casual tote bag
• Basket 2: A bottle holder, green carabiner, copper vacuum insulated bottle, Arctic Zone thermal copper mug and a domino set inside a black tote bag

You pay nothing

Behavioral Health - Individual Therapy Sessions to Caregivers

As needed, for family caregivers of members Age 18 and older

You pay nothing

Day Trip - Meal Reimbursement/ Allowance

Members Age 21 and older, up to $1000 a year for same-day medical trips more than 100 miles from home

You will be refunded

Durable Medical Equipment Services and Supplies

You are covered for the following:

Members Age 21 and older that are under care management with blood pressure monitoring included in their care plan, may receive 1 digital blood pressure cuff every 3 years

You pay nothing

Fall Prevention Kit

Members Age 18 and older who are at risk for falls may receive a Fall Prevention kit once per lifetime. Kit contains:

Non-Slip Socks

Reacher/Grabber

Bath Mat

Stair Treads

Member must not reside in a residential facility or nursing facility

You pay nothing

Hearing Services for Adults

You are covered for medically necessary hearing screenings and diagnostic testing.

For members Age 21 and older, the plan covers:

• 1 hearing aid assessment, fitting, checking, and evaluation every 2 years
• 1 in ear monaural hearing aid per ear annually
• 1 hearing aid, all other types, per ear every two 2 years

Call Hear USA at 877-664- 9353 for a hearing provider near you

You pay nothing

Hospital Services - Outpatient

Members Age 21 and older, no monetary limit on outpatient services.

You pay nothing

Non Medical Transportation for LTC

Members Age 21 and older, this benefit covers 2 roundtrip services per month. The trips must be within your local area.

This benefit is for members who live in a home or community- based setting

You pay nothing

Over-the- Counter (OTC) Medications and Supplies

$50 per month allowance enables households to purchase products that support common occurring conditions such as:

• Pain relievers 
• Diaper rash cream
• Cough and cold relief medicine
• First aid equipment that do not require prescriptions.

Unused amounts do not roll over to the next month.

You pay nothing

Smartphone Service

Smartphones can provide easy access to health related information and enable members to stay connected to their care team and health plan. Humana members that qualify for the Federal Lifeline program are eligible to receive a free smartphone with monthly talk minutes, text and data.

You pay nothing.

Support to Stay in Community Living

$1,000 allowance to support LTC members Age 18 and older to remain in their home or transition into an assisted living facility (ALF). Once per lifetime.

Approved expenses may include utilities (gas, water, electric), internet, furniture, or rent with a long-term financial plan. 

Members must meet the following criteria:

• Member must live in the community and be at risk for long-term institutional placement
• Member must live alone or with spouse (other living situations may be approved on a case-by-case basis upon Care Manager review)
• Member must show proof of potential loss of dwelling or risk of losing home due to inability to pay utilities, late bills/disconnection notices, etc.
• Benefit allowed only for items that place member at risk for custodial placement
• Benefit cannot be used concurrently with SMI Specialty Housing Assistance benefit

You pay nothing

Transition Assistance into Community Living

Members Age 18 and older who are moving from a nursing facility into their own home may receive up to up to $5,000 per lifetime. 

• Assistance for paying with security and utility deposits, household furnishings/supplies, and moving expenses
• Member must be responsible for their own living expenses

You pay nothing

Waived copayments

No copays on any services