Mma Florida

Humana Medical Plan

If you are eligible for Medicaid in Florida, find out if the Humana Medical plan is right for you.

This plan is available to people who live in these Florida counties:

  • Escambia, Okaloosa, Santa Rosa, and Walton
  • Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla, and Washington (effective 2/1/2019)
  • Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee, and Union (effective 2/1/2019)
  • Baker, Clay, Duval, Flagler, Nassau, St. Johns, and Volusia (effective 2/1/2019)
  • Pasco and Pinellas
  • Hardee, Highlands, Hillsborough, Manatee, and Polk
  • Brevard, Orange, Osceola, and Seminole
  • Charlotte, Collier, Desoto, Glades, Hendry, Lee, and Sarasota
  • Indian River, Martin, Okeechobee, Palm Beach, and St. Lucie
  • Broward
  • Miami-Dade and Monroe
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.

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.
Don't forget to schedule yours and/or your child's free yearly well-visit and dental checkup. Call your doctors or call Customer Service at 1-800-477-6931 (TTY: 711) to schedule appointments today; and remember these visits are at no cost to you!
It is important to maintain a healthy diet and weight. Humana offers nutritional counseling for free. Call Customer Service at 1-800-477-6931 (TTY: 711) and ask about the benefit.
We are excited to announce the following Urgent Care Centers have joined our network:
  • MD Now
    • 9 locations in Broward County
    • 11 locations in Miami-Dade County
    • 10 locations in Palm Beach County
  • Community Health of South Florida
    • 2 locations in Cutler Bay and Homestead

For location information, click on the “Provider Directory” link for your region or the “Find a doctor” link to use the online tool. Or you can call Customer Service at 1-800-477-6931 (TTY: 711), Monday-Friday from 8:00 a.m. to 8:00 p.m.

Plan documentation

Details and documents related to Humana Medical plan. If you would like to receive any of these documents in a printed format (at no cost), please call Customer Service at 1-800-477-6931 (TTY: 711).

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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

Effective February 1, 2019

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

Region 3

Effective February 1, 2019

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

Region 4

Effective February 1, 2019

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

Region 5

Effective January 1, 2019

Counties: Pasco and Pinellas

Region 6

Counties: Hardee, Highlands, Hillsborough, Manatee and Polk

Region 7

Effective January 1, 2019

Counties: Brevard, Orange, Osceola and Seminole

Region 8

Effective January 1, 2019

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

Coverage determination

For questions about which prescription drugs are covered, please contact Humana’s Clinical Pharmacy Review department at 1-800-555-2546, 8 a.m. – 8 p.m. Eastern time, Monday – Friday.

Transportation services

If you need a ride to a health care appointment that is not an emergency call LogistiCare at 1-866-779-0565. You must call at least 24 hours before your appointment time. For emergency transportation services, call 911. May need prior authorization or a referral.

Humana Long-Term Care

If you are eligible for long-term care services through Medicaid, our Long-Term Care plan may help you make the most of your benefits.

Contact us

Humana can help you understand the Humana Medical plan, and help you make sense of your options in Florida, or if you have questions about your health, you can speak to a nurse at any time, 24 hours a day.

Call us

1-800-477-6931
(TTY users: 711)
We’re here from 8 a.m. to 8 p.m. Eastern time, Monday – Friday. The call is free.
For more information, visit Florida Department of Children and Families(link opens in new window) 
Questions about Florida Medicaid? Please visit http://ahca.myflorida.com/Medicaid/statewide_mc/pdf/mma/SMMC_MMA_Snapshot.pdf(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) .

Humana Inc.
500 W. Main St.
Louisville, KY 40202