Below, you’ll find key plan documents and forms for the 2025 plan year. You can open and/or download each form as needed. These documents are effective from January 1, 2025 through December 31, 2025.
2025 documents and forms
2025 Member Handbook – English
2025 Member Handbook – Spanish
2025 Prescription Drug Guide – English
2025 Prescription Drug Guide – Spanish
2025 Summary of Benefits – English
2025 Summary of Benefits – Spanish
2025 Annual Notice of Changes – English
2025 Annual Notice of Changes – Spanish
Learn more about these available federal programs
Learn how Humana uses and protects your health information.
Privacy Notice – English
HIPAA – Aviso de Prácticas de privacidad
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.
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.
2025 Illinois Prior Authorization Criteria
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