General Expanded Benefits

Print
Benefit/Service
Description
Doula services
  • Emotional and physical support to the laboring mother and her family
  • 4 prenatal visits
  • 4 postpartum visits
  • 1 visit for delivery assistance per pregnancy

Learn more about our Moms First program for our pregnant and new moms 
Legal guardianship
  • Up to $500 per lifetime for members ages 17 and older in a skilled nursing facility (SNF) or private duty nursing (PDN) setting, and their parent is obtaining guardianship to protect individuals unable to care for their own well-being
  • If your child receives Private Duty Nursing (PDN) services, you can report missed nurse visits. If your child’s nurse does not arrive at the scheduled time, please call the toll-free number 24 hours per day, 365 days per year, including holidays and weekends 800-530-1446. The on-call coordinator will notify your Care Manager and work with you and your home health agency to find a resolution within 24 hours of reporting the missed visit.

    To report missed visits please contact us by either email or phone. This email and telephone will be available 24 hours per day, 365 days per year:

    • During the hours of Monday-Friday 8:00AM-5:00PM, please call your Care Manager or 800-530-1446.
    • After hours, on weekends, or on holidays, please call our new toll-free number 800-530-1446.
    • You may email HumanaFLMedicaidPEDPDN@Humana.com to report the missed PDN missed visits.

    When you email or leave a message, please include the following information about yourself (or our member, if someone is reporting an issue on behalf of our member):

    • First and last name
    • Date of birth
    • Humana Member ID or Medicaid ID, if available
    • How to get back to you (for example, best contact phone number, email address)
    • Date & time of PDN missed visit & reason for missed visit

Care manager approval required
Meals – Disaster Preparedness/Relief
One box of 10 shelf-stable meals prior to a hurricane or other disaster twice annually

Call Member Services at 800-477-6931 (TTY: 711), Monday – Friday, from 8 a.m. – 8 p.m., Eastern time for more information.

Administrative approval required
Meals – Post-Discharge
1 box of 10 meals per discharge as approved by Care Manager

No limit on the number of meals per year
Newborn Circumcision
One per lifetime
Pharmacy Over-The-Counter Allowance

Up to $25 per household per month purchase over-the-counter (OTC) drugs and supplies from the Centerwell Pharmacy.

Unused amounts do not carry over to the next month.

Visit our Pharmacy webpage for more information

Prenatal services
  • Rental of hospital-grade breast pump: 1 per year
    Prior authorization required
  • Rental of regular breast pump: 1 every 2 years
  • 14 prenatal visits (during low-risk pregnancy)
  • 18 prenatal visits (during high-risk pregnancy)
  • 3 postpartum visits within 90 days after delivery

Learn more about our program for pregnant members and new moms

Prevention kit – Flu/Pandemic
A flu/pandemic prevention kit that includes:

  • 10 3-ply face masks
  • Hand sanitizer
  • Oral digital thermometer

Available to first 1,000 Humana Healthy Horizons in Florida members (18 and older) who get a flu vaccine

We will send kits to qualifying members

Care Manager approval required
Smartphone Services

Through the Federal Lifeline Program, households may be eligible for 1 smartphone with monthly minutes, text and data.

Members who are under 18 will need a parent or guardian to sign up. Smartphone training for you and your caregiver during your case manager visits can be requested.

Members may also qualify for enhanced benefits through the Affordable Connectivity Program (ACP) that provides additional minutes, data and/or hotspot access.

Visit SafeLink at https://safelinkwireless.com to apply.

Limitations may apply and are subject to change per FCC guidelines.

Adult Expanded Benefits (For members 21 and older)

Print
Benefit/Service
Description
Acupuncture services
Unlimited visits for pain management
Behavioral health assessment/evaluation services
Unlimited
Behavioral health computerized cognitive behavioral therapy
Unlimited
Behavioral health day services/day treatment
Unlimited
Behavioral health group therapy
Unlimited
Behavioral health home visits by a clinical social workers
Unlimited
Behavioral health individual and family therapy
Unlimited
Behavioral health intensive outpatient treatment
Unlimited
Behavioral health medical services (e.g., medication management, drug screening, etc.)
Unlimited:

  • Drug screening
  • Verbal interaction
  • Medication management
Behavioral health medication-assisted treatment services
Unlimited
Behavioral health psychosocial rehabilitation
Unlimited
Behavioral health screening services
Unlimited
Behavioral health substance abuse treatment or detoxification services (outpatient)
Unlimited
Behavioral health targeted case management
Unlimited
Behavioral health therapeutic behavioral on-site services
Unlimited
Chiropractic services
Unlimited visits for pain management
Durable medical equipment/supplies
  • CPAP machines and oxygen
    • Unlimited continuous air pressure device – CPAP/APAP; concentrator; portable gaseous oxygen system
    • Prior authorization required
    • Care manager approval required
  • Glucose pods
    • Unlimited, prior authorization required
  • Monitoring supplies for continuous glucose monitoring
    • Unlimited external ambulatory insulin delivery system, disposable; blood glucose test or reagent strips for home blood glucose monitor; sensor; transmitter external, for use with interstitial continuous glucose monitoring system; receiver (monitor) external, for use with interstitial continuous glucose monitoring system
    • Prior authorization required

Biometric equipment:
  • Members under care management for congestive heart failure can receive 1 weight scale every three years
  • Members under care management for hypertension or pre-eclampsia can receive 1 digital blood pressure cuff every three years
    • Care manager approval required
Financial literacy

Access to a financial resource center for:

  • Up to 6 life coaching sessions for money management/budgeting
  • Access to financial vendor for personal financial coaching, investment education, credit counseling, tax consultation and a 25% discount on tax preparation


To get started, call 855-330-8053 and select option 3

Hearing services
  • One hearing aid assessment, reassessment, fitting, checking, and evaluation every two years

Hearing aids and dispensing fees:
  • Monaural In Ear hearing aid - 1 per ear every year
  • Behind Ear Bicros hearing aid - 1 per ear every 2 years
  • Behind Ear Binaural hearing aid - 1 per ear every 2 years
  • Behind Ear Cros hearing aid - 1 per ear every 2 years
  • Behind Ear hearing aid - 1 per ear every 2 years
  • In Ear Binaural hearing aid - 1 per ear every 2 years
Hospital Services – Outpatient
The $1,500 fiscal year dollar limit for non-emergency outpatient services is waived
Housing assistance
$500 per household, per lifetime maximum

Call Member Services at 800-477-6931 (TTY: 711), Monday – Friday, from 8 a.m. – 8 p.m., Eastern time for more information
Meals – Day Trip – Meal reimbursement/allowance
Reimbursement for $200 per day, up to $1,000 per year for trips greater than 100 miles

Care Manager approval required

Humana will reimburse member after member submits receipts

Call Member Services at 800-477-6931 (TTY: 711), Monday – Friday, from 8 a.m. – 8 p.m., Eastern time for more information
Meals – Home Delivered
10 home-delivered meals per year. Care manager approval required. Call Member Services at 800-477-6931 (TTY: 711), Monday – Friday, from 8 a.m. – 8 p.m., Eastern time for more information.
Nutritional counseling
Unlimited
  • Individual nutrition therapy initial assessment and intervention, 15 minutes each
  • Individual nutrition therapy re-assessment and intervention, 15 minutes each
  • Individual nutrition therapy re-assessment and subsequent interventions for change in diagnosis, 15 minutes each
  • Group nutrition therapy, 30 minutes each
  • Group nutrition therapy re-assessment and subsequent interventions for change in diagnosis, 30 minutes each

Requires primary care provider referral
Primary care services
Unlimited per month for non-pregnant members
Therapy – Massage
Unlimited visits for pain management
  • Therapeutic Procedure, 15 minutes. Mobilization, manipulation, manual lymphatic drainage, manual
  • Hot and cold pack therapy -Hydro Therapy
  • Neuromuscular Therapy
  • Therapeutic procedure, 1 or more areas, each 15 minutes massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)

Referral required (but it does not need to be from your primary care provider)
Therapy – Occupational
One evaluation and re-evaluation per year, and up to seven therapy treatment units per week

No prior authorization needed for initial assessment

Prior authorization required for ongoing treatment
Therapy – Physical services
1 evaluation and re-evaluation per year, and up to seven therapy treatment units per week

No prior authorization needed for initial assessment

Prior authorization required for ongoing treatment
Therapy – Respiratory services
1 evaluation and re-evaluation per year, and 1 therapy treatment per day

No prior authorization needed for initial assessment

Prior authorization required for ongoing treatment
Therapy – Speech-language pathology services
  • Once yearly: evaluation and re-evaluation
  • Once yearly: Evaluation of oral and pharyngeal swallowing function
  • Up to seven therapy treatment units per week
  • One augmentative and alternative communication (AAC) initial evaluation and re-evaluation per year
  • Up to 4 30-minute AAC fitting, adjustment, and training visits per year for 30 minutes each

No prior authorization needed for initial assessment

Prior authorization required for ongoing treatment
Vaccine – Influenza
Unlimited
Vaccine – Pneumonia
Unlimited
Vaccine – Shingles
One per year
Vaccine – TDaP
One vaccine per pregnancy
Visual aid services
One eye exam per year and one of the following:

  • One pair of frames* a year, or
  • A six-month supply of contact lenses with a doctor’s prescription

*Member pays any cost that exceeds $75 for luxury frames
Waived Copayments
No copays on any services

Expanded Benefits (For members under 21)

Print
Benefit/Service
Description
Go365 for Humana Healthy Horizons®

Access to a pediatric wellness program

Learn more about Go365 for Humana Healthy Horizons

Swimming lessons (drowning prevention)
$200 a year for up to 1,000 enrollees (children up to age 21)

Humana will reimburse member after member submits receipts

Call Member Services at 800 477 6931 (TTY: 711), Monday – Friday, from 8 a.m. – 8 p.m., Eastern time for more information
Tutoring

Members in grades K-12 can access online tutoring services for 2 hours per week

Learn more about this expanded benefit

Covered Health Management Programs

Print
Benefit/Service
Description
Care management
For all members, complex care management and care management for chronic conditions, including:

  • Asthma
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Heart failure
  • Hypertension

Call Member Services at 800-477-6931 (TTY: 711), Monday – Friday, from 8 a.m. – 8 p.m., Eastern time for more information
Specialty program
For all members, access to specialty programs and services related to:

  • Alzheimer’s Disease
  • HIV/AIDS
  • Pain management
  • Palliative care
  • Sickle cell disease
  • Social work