To make the most of your health plan, find the documents and forms you need, including:
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Your healthcare is our priority. We know your private duty nursing (PDN) services are important. Your relationship with the agency providing the services is important, too.
To make sure you get the high-quality care you need and deserve, we put in place a new way to report your issues and concerns in real time. Issues and concerns may include problems like:
- Nurses missing shifts
- Nurses no-shows
- No nurse available
Learn more about our real-time reporting requirements and process
Member materials
Do you have any questions about your plan? Check out the Member Handbook to find full details of your plan and benefits. You can find information about the Humana Medical Plan, Humana Long-Term Care Plan, and Humana Comprehensive Plan.
To find a doctor or other healthcare provider or facilities:
- Use our Find a doctor service
- Use the below directories to see a list of in-network providers and facilities in your area
Region 1
Counties: Escambia, Okaloosa, Santa Rosa and Walton
Provider Directory – English and Spanish (FL counties: Bay, Escambia, Holmes, Okaloosa, Santa Rosa, Walton, and Washington; AL counties: Baldwin, Covington, Escambia, Geneva, Houston, and Mobile; GA counties: Cook, Dekalb, Glynn and Lowndes)
Long-Term Care Provider Directory – English and Spanish (Escambia, Okaloosa, Santa Rosa, Walton, Bay, Holmes, and Washington counties)
Region 2
Counties: Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla, and Washington
Provider Directory – English and Spanish (Bay, Calhoun, Dixie, Franklin, Gadsden, Gulf, Hamilton, Holmes, Jackson, Jefferson, Lafayette, Leon, Liberty, Madison, Suwanee, Taylor, Wakulla, Walton, and Washington counties)
Long-Term Care Provider Directory – English and Spanish (Bay, Calhoun, Franklin, Gadsden, Gulf, Hamilton Holmes, Jackson, Jefferson, Leon, Lafayette, Liberty, Madison, Taylor, Wakulla, Washington, Dixie, Suwanee, and Walton counties)
Region 3
Counties: Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee, and Union
Provider Directory – English and Spanish (Alachua, Bradford, Citrus, Columbia, Dixie, Lake and Volusia counties)
Provider Directory – English and Spanish (Baker, Clay, Flagler, Levy, Marion, Pasco, Putnam, Sumter, Suwanee, and Union counties)
Provider Directory – English and Spanish (Polk, Seminole, St. Johns, and Taylor counties)
Provider Directory – English and Spanish (Gilchrist, Hamilton, Hernando, and Lafayette counties)
Provider Directory – English and Spanish (Hillsborough county)
Provider Directory – English and Spanish (Madison, and Osceola counties)
Provider Directory – English and Spanish (Orange county)
Provider Directory – English and Spanish (Madison, Orange, and Osceola counties)
Long-Term Care Provider Directory – English and Spanish (Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwanee, and Union counties)
Long-Term Care Provider Directory – English and Spanish (Baker, Clay, Flagler, Hillsborough, Madison, and Orange counties
Long-Term Care Provider Directory – English and Spanish (Osceola, Pasco, Polk, Seminole, St. Johns, Taylor, and Volusia counties)
Region 4
Counties: Baker, Clay, Flagler, Nassau, and Volusia
Provider Directory – English and Spanish (Baker, Clay, Duval, Flagler, Nassau, St. Johns, and Volusia counties)
Provider Directory – English and Spanish (Alachua, Bradford, Brevard, Columbia, Lake, Marion, and Union counties)
Provider Directory – English and Spanish (Orange county)
Provider Directory – English and Spanish (Putnam, and Seminole counties)
Provider Directory – English and Spanish (Duval and St. Johns counties)
Long-Term Care Provider Directory – English and Spanish (Baker, Clay, Duval, Flagler, Nassau, St. Johns, and Volusia counties)
Long-Term Care Provider Directory – English and Spanish (Alachua, Bradford, Brevard, Columbia, Lake, Marion, Orange, Putnam, Seminole, and Union counties)
Region 5
Counties: Pasco and Pinellas
Provider Directory – English and Spanish (Lake, Pasco, Polk, and Sumter counties)
Provider Directory – English and Spanish (Citrus and Hernando counties)
Provider Directory – English and Spanish (Hillsborough county)
Provider Directory – English and Spanish (Pinellas county)
Long-Term Care Provider Directory – English and Spanish (Citrus, Hernando, Hillsborough, Lake, Pasco, Pinellas, Polk, and Sumter counties)PDF
Region 6
Counties: Hardee, Highlands, Hillsborough, Manatee and Polk
Provider Directory – English and Spanish (Hillsborough county)
Provider Directory – English and Spanish (Manatee county)
Provider Directory – English and Spanish (Desoto, Glades, Hernando, Lake, Okeechobee, Polk, Sarasota, and Sumter counties)
Provider Directory – English and Spanish (Hardee, Highlands, Osceola, and Pinellas counties)
Provider Directory – English and Spanish (Charlotte and Pasco counties)
Provider Directory – English and Spanish (Orange county)
Long-Term Care Provider Directory – English and Spanish (Hardee, Highlands, Hillsborough, Manatee, and Polk counties)
Long-Term Care Provider Directory – English and Spanish (Charlotte, DeSoto, Glades, Hernando, Lake, Okeechobee, Orange, Osceola, Pasco, Pinellas, Sarasota, and Sumter counties)
Region 7
Counties: Brevard, Orange, Osceola, and Seminole
Provider Directory – English and Spanish (Highlands, Indian River, and Lake counties)
Provider Directory – English and Spanish (Polk, St. Lucie, and Volusia counties)
Provider Directory – English and Spanish (Okeechobee, and Osceola counties)
Provider Directory – English and Spanish (Orange county)
Long-Term Care Provider Directory – English and Spanish (Highlands, Indian River, Osceola, St. Lucie and Seminole counties)
Long-Term Care Provider Directory – English and Spanish (Brevard, Lake, Okeechobee, Orange, Polk, and Volusia counties)
Region 8
Counties: Charlotte, Collier, Desoto, Glades, Hendry, Lee, and Sarasota
Provider Directory – English and Spanish (Charlotte, Collier, DeSoto, Glades, Hardee, Hendry, Highlands, Lee, and Sarasota counties)
Provider Directory – English and Spanish (Hillsborough county)
Provider Directory – English and Spanish (Manatee county)
Provider Directory – English and Spanish (Monroe county)
Provider Directory – English and Spanish (Okeechobee and Palm Beach counties)
Long-Term Care Provider Directory – English and Spanish (Charlotte, Collier, DeSoto, Glades, Hendry, Lee, and Sarasota counties)
Long-Term Care Provider Directory – English and Spanish (Broward, Hardee, Highlands, Hillsborough, and Manatee counties)
Long-Term Care Provider Directory – English and Spanish (Okeechobee and Palm Beach counties)
Long-Term Care Provider Directory – English and Spanish (Miami-Dade and Monroe counties)
Region 9
Counties: Indian River, Martin, Okeechobee, Palm Beach, and St. Lucie
Provider Directory – English and Spanish (Brevard, Glades, Indian River, Martin, Okeechobee, and St. Lucie counties)
Provider Directory – English and Spanish (Palm Beach county)
Provider Directory – English and Spanish (Hendry, Highlands, Osceola, and Polk counties)
Long-Term Care Provider Directory – English and Spanish (Indian River, Martin, Okeechobee, Palm Beach, and St. Lucie counties)
Long-Term Care Provider Directory – English and Spanish (Brevard, Broward, Glades, Hendry, Highlands, Osceola, and Polk counties)
Region 10
Counties: Broward
Provider Directory – English and Spanish (Broward county) – Behavioral Health Services, Durable Medical Equipment, Hospitals, Laboratory Services, Pharmacies, Primary Care Providers, Urgent Care Centers, and Vision Providers
Provider Directory – English and Spanish (Broward county) – Other Healthcare Providers and Specialists
Provider Directory – English and Spanish (Collier and Palm Beach counties)
Provider Directory – English and Spanish (Hendry county)
Long-Term Care Provider Directory – English and Spanish (Broward, Collier, and Palm Beach counties)
Long-Term Care Provider Directory – English and Spanish (Hendry and Miami-Dade counties)
Region 11
Counties: Miami-Dade and Monroe
Provider Directory – English and Spanish (Miami-Dade county)
Provider Directory – English and Spanish (Collier, Monroe and Palm Beach counties)
Provider Directory – Specialists – English and Spanish (Miami-Dade county)
Long-Term Care Provider Directory – English and Spanish (Miami-Dade and Monroe counties)
Long-Term Care Provider Directory – English and Spanish (Broward, Collier, and Palm Beach counties)
Participant Direction Option
Find more information about another option for your long-term care plan—the Participant Direction Option (PDO). The PDO allows you to self-direct your services.
Learn more about PDO
Pharmacy resources
We know understanding your medicine coverage is important. Check the lists below to see the medicines your plan covers.
Preferred Drug List (English and SpanishPDF)
Cystic Fibrosis Supplemental Drug List – English (1.15 MB)
Cystic Fibrosis Supplemental Drug List – Spanish (1.09 KB)
Recent changes to Florida Medicaid Drug List
Over-the-counter (OTC) order forms
Your pharmacy benefit lets you order certain over-the-counter (OTC) items through the mail. Use this catalog to look up OTC items you want to order each month. Fill out the form and mail, fax or phone your order to CenterWell Pharmacy™.
Contact us
Combined Humana Medical and Long-Term Care (LTC) OTC form
Over-the-Counter Order Form—English (1.19 MB)
Over-the-Counter Order Form—English/Spanish (838 KB)
Prescription drug reimbursement claim form
We hope you don't have to pay for any medicine out of pocket. If it happens, let us know by filling out a reimbursement claim form, and we will try to pay you back.
Fill out the form below to send in a reimbursement claim if you paid out of pocket for a prescription.
Prescription drug reimbursement claim form (611 KB)
Legal and privacy notices
These notices provide information about how Humana uses, and when we might share, your personal information.
They also outline the various privacy rights available to you.
Individual privacy rights—English and Spanish
Rights and responsibilities—English
Rights and responsibilities—Spanish
HIPAA privacy notice—English (119 KB)
HIPAA Privacy Notice – Spanish (111 KB)
Living will
A living will is an important document every adult should complete. A living will lets you clarify in writing what you want family or other healthcare proxy to do if you’re not in a position to make healthcare decisions for yourself.
Living will – English and Spanish
Detecting, Preventing, and Reporting Healthcare Fraud
Detecting, Preventing, and Reporting Healthcare Fraud
Grievance and appeals
We want you to be happy with the care you get from Humana Healthy Horizons in Florida. We hope you get the best care possible.
If you are not happy with any part of your healthcare plan, Customer Care, your doctor, or a facility, you can send in a grievance. You also can appeal a claim or a denied service using this form.
If you are sending an appeal or grievance for another covered member, be sure to fill out an Appointment of Representative form.
Download and return to us the completed forms:
Grievance/Appeal request form—English (157 KB)
Grievance/Appeal request form—Spanish (157 KB)
Appointment of Representative form—English/Spanish (157 KB)
Your appeal rights, as listed in the Member Handbook (154 KB)
Caregiver forms
If you want your caregiver to have access to your health information, you need to fill out the protected health consent form.
Download and complete the forms and return the completed forms to us.
Medical
Consent for Release of Protected Health Information (2.6 MB) English
Consent for Release of Protected Health Information (2.6 MB) Spanish
Access Behavioral Health Consent for Release of PHI (Regions 1 & 2) PDF (195 KB) English
Carelon Behavioral Health Consent for Release of PHI (Regions 3–11) PDF (152 KB) English
Long-Term Care (LTC)
LTC Consent to Share Health Facts (38 KB) English
LTC Consent to Share Health Facts (38 KB) Spanish
LTC Consent for Release of Information (965 KB) English
LTC Request for Alternative Communications (396 KB) English
Performance measurement surveys
Let us know how we are doing. We want to make sure we are giving you the best care and services to manage your health. Download performance measurement reports and take our member satisfaction survey.
Guide to HEDIS® measurements
State of Health Care Quality Report (NCQA website)
Health Risk Assessment (HRA)
You can complete your HRA by:
- Filling out the HRA in your Welcome Kit and sending it back to us in the postage-paid envelope (also in your Welcome Kit), or
- Calling us at 800-611-1467 (TTY: 711), or
- Registering for a MyHumana
If you have a care coordinator or care manager, he or she may ask you to print and complete the below HRA:
Take our health risk assessment (877 KB) English
Take our health risk assessment (872 KB) Spanish
Take our health risk assessment (872 KB) Creole
Smartphone benefit information
Through the Federal Lifeline Program, households may be eligible for a smartphone with monthly minutes, text and data. Visit SafeLink to apply.
Expanded Benefits and Overnight Reimbursement Form
We hope you don’t have to pay out of pocket for the benefits you get as a Humana Healthy Horizons in Florida member. If you do, let us know by filling out a reimbursement claim form, and you may get a refund.
Fill out one of the forms below to send a reimbursement claim.
Expanded Benefits Reimbursement Form – English
Expanded Benefits Reimbursement Form – Spanish
Medicaid Overnight Reimbursement Form – English
Medicaid Overnight Reimbursement Form – Spanish
