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Humana Long-Term Care

If you receive Medicaid in Florida, you may qualify for Humana’s Long-Term Care plan. Florida offers a long-term care program to people age 65 and older who require nursing home-level care, and people age 18 or older who are eligible for Medicaid due to disability and require nursing home-level care.

The Humana Long-Term Care plan covers services provided by nursing homes, assisted living facilities and in-home, community-based settings throughout the entire state of Florida.

The Agency for Health Care Administration (Agency) contracts with Medicaid health and dental plans to provide services to health plan enrollees in the Statewide Medicaid Managed Care (SMMC) program. The Agency recently entered into new contracts with health and dental plans. As part of those contracts, the Agency achieved program changes that greatly benefit enrollees and providers.

The Agency will transition to the new contracts through a regional phased roll-out. The first regional roll-out occurred on Saturday, December 1, 2018. Roll-out for phase two will occur January 1, 2019. Roll-out for phase three will occur February 1, 2019.

Health and dental plans are required to ensure continuity of care (COC) during the transition period for Medicaid recipients enrolled in the SMMC program. COC requirements ensure that when enrollees transition from one health plan to another, one service provider to another, or one service delivery system to another (i.e., fee-for-service to managed care), their services continue seamlessly throughout their transition. The Agency has instituted the following COC provisions:
  • Health care providers should not cancel appointments with current patients. Health plans must honor any ongoing treatment that was authorized prior to the recipient’s enrollment into the plan for up to 60 days after the roll-out date in each region.
  • Providers will be paid. Providers should continue providing any services that were previously authorized, regardless of whether the provider is participating in the plan’s network. Plans must pay for previously authorized services for up to 60 days after the roll-out date in each region, and must pay providers at the rate previously received for up to 30 days.
  • Providers will be paid promptly. During the continuity of care period, plans are required to follow all timely claims payment contractual requirements. The Agency will monitor complaints to ensure that any issues with delays in payment are resolved.
  • Prescriptions will be honored. Plans must allow recipients to continue to receive their prescriptions through their current provider, for up to 60 days after the roll-out date in each region, until their prescriptions can be transferred to a provider in the plan’s network.
More information about COC provisions can be referenced on the COC program highlight document, which is posted on the Agency’s website at www.ahca.myflorida.com/smmc(link opens in new window). Once on the page, click Program Changes, then the Outreach and Presentations link.

Plan documentation

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See details and documents related to your county/region below.

Region 1

Counties: Escambia, Okaloosa, Santa Rosa and Walton

Region 2

Counties: Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla and Washington

Region 3

Counties: Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee and Union

Region 4

Counties: Baker, Clay, Duval, Flagler, Nassau, St. Johns and Volusia

Region 5

Counties: Pasco and Pinellas

Region 6

Counties: Hardee, Highlands, Hillsborough, Manatee and Polk

Region 7

Counties: Brevard, Orange, Osceola and Seminole

Region 8

Counties: Charlotte, Collier, Desoto, Glades, Hendry, Lee and Sarasota

Region 9

Counties: Indian River, Martin, Okeechobee, Palm Beach and St. Lucie

Region 10

Counties: Broward

Region 11

Counties: Miami-Dade and Monroe

Contact us

Humana can help you understand the Humana Long-Term Care plan benefits, help figure out if you qualify, and make sense of your options in Florida.

Call us

1-888-998-7732 (TTY users: 711)

We’re here from 8 a.m. - 8 p.m., Monday - Friday. The call is free.
To learn more about the Florida Department of Children and Families, visit their website at www.myflfamilies.com(link opens in new window) .
To contact the Florida Agency for Health Care Administration, visit their website at http://ahca.myflorida.com/(link opens in new window) .
To learn more about Florida Medicaid Quality, visit their website at http://ahca.myflorida.com/Medicaid/quality_mc/submission.shtml(link opens in new window)