Below, you’ll find key plan documents and forms for the 2024 plan year. You can open and/or download each form as needed. These documents are effective from January 1, 2024 through December 31, 2024.
2024 documents and forms
You may qualify for discounts on your broadband Internet service and the purchase of eligible computers and tablets. Also, enrollment in a Medicaid plan, like Humana Gold Plus Integrated, qualifies you for a free phone, talk, text, data, and more through Safelink Wireless.
Learn how Humana uses and protects your health information.
If you want someone to act on your behalf with us, he or she needs to complete and return to us an Appointment of Representative Form.
Learn more about how we can help you in a language other than English.
Notice of Non-Discrimination
Humana Inc. and its subsidiaries comply with applicable Federal civil rights laws and do not discriminate or exclude people because of their race, color, religion, gender, gender identity, sex, sexual orientation, age, disability, national origin, military status, veteran status, genetic information, ancestry, ethnicity, marital status, language, health status, or need for health services.
Notice of Availability of Language Assistance Services and Auxiliary Aids and Services
Humana Inc. and its subsidiaries comply with Section 1557 by providing free auxiliary aids and services to people with disabilities when auxiliary aids and services are necessary to ensure an equal opportunity to participate.
Auxiliary Aids and Services Notice – English
Auxiliary Aids and Services Notice – Spanish
Pharmacy forms
Learn more about our process for reviewing and giving prior authorization and our step-therapy criteria.
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Use this Find a Dental Provider service to find a dentist near you.