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Oklahoma SoonerSelect: Documents and Forms

Find the documents and forms Sooner Select enrollees need to get the most from their enrollment.

Key plan documents

Welcome Kit

All new members get a Welcome Kit in the mail. You also can view it below. Your Welcome Kit includes the information you need at the start of your enrollment in Humana Healthy Horizons® in Oklahoma.

Welcome Kit (English)

Welcome Kit (Spanish)

Health Risk Screening (HRS)

The answers you give us on your HRS help us make sure you get the care you need. Your Welcome Kit includes a HRS form and postage-paid envelope in which to return your completed HRS. You also can download a HRS below.

Health Risk Screening (English)

Health Risk Screening (Spanish)

Your Welcome Kit includes information about the many ways you can return your completed HRA to us.

Member Handbook

Have questions about your plan, benefits, and covered services? Check out your Member Handbook.

Member Handbook (English)

Member Handbook (Spanish)

Preferred Drug List

The Preferred Drug List is a list of drugs and medicine your plan covers. Your doctor can prescribe you drugs and medicine on this list if needed. We update our Preferred Drug List periodically during the year. If we update the Preferred Drug List, we will notify you and we will make the new version available below.

Preferred Drug List (English)

Preferred Drug List (Spanish)

Pharmacy forms

Over-the-counter (OTC) catalog and order form

Your pharmacy benefit lets you order certain over-the-counter (OTC) items through the mail. To get started:

  • Look up available OTC items in the Humana Health and Wellness Catalog and Order Form
  • Write down your order on the Order Form
  • Submit your order:
    • By mail:

      CenterWell Pharmacy
      P.O. Box 1197
      Cincinnati, OH 45201-1197
  • By phone: Call CenterWell Pharmacy at 855-211-8370 (TTY: 711). Customer Care Representatives are available Monday – Friday, 8 a.m. – 11 p.m. and Saturday, 8 a.m. – 6:30 p.m., Central time.
  • By fax: 800-379-7617

Call the number on the back of your ID card if you have questions about your benefit.

Humana Health and Wellness Catalog and Order Form (English), PDF

Humana Health and Wellness Catalog and Order Form (Spanish), PDF

Prescription drug reimbursement claim form

We hope you don’t have to pay for any medicine out of pocket. If it happens, please fill out the form below to send in a reimbursement claim if you paid out of pocket for a prescription. We will try to pay you back.

Prescription Drug Claim Form for Member Reimbursement (English), PDF

Prescription Drug Claim Form for Member Reimbursement (Spanish), PDF

Legal and privacy notices

The legal and privacy notices below provide information about:

  • How Humana uses, and when we might share, your personal information
  • Your privacy rights

Individual privacy rights (English)

Individual privacy rights (Spanish)

Rights and responsibilities (English)

Rights and responsibilities (Spanish)

HIPAA privacy notice (English)

HIPAA privacy notice (Spanish)

To give us permission to share your medical information with someone, you must complete and send back to us a Consent for Release of Medical Information and a Consent for Release of Protected Health Information.

Sensitive protected health information (PHI) provider consent (English), PDF

Sensitive protected health information (PHI) provider consent (Spanish), PDF

Consent for Release of Protected Health Information (English), PDF

Consent for Release of Protected Health Information (Spanish), PDF

Detecting, Preventing, and Reporting Healthcare Fraud, PDF

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.

Non-Discrimination Notice – English 

Non-Discrimination Notice – Spanish 

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

Performance measurement

Refer to the below information to see how we’re measured as a health plan, and also how we’re doing.

Guide to HEDIS® measurements

State of Health Care Quality Report (NCQA)

Expanded Benefits Reimbursement Form

We hope you don’t have to pay out of pocket for the benefits you get as a Humana Healthy Horizons in Oklahoma enrollee. If you do, let us know by filling out a reimbursement claim form, and you may get a refund.

Fill out the form below to send a reimbursement claim.

Expanded Benefits Reimbursement Form (English), PDF

Expanded Benefits Reimbursement Form (Spanish), PDF

Advance Directives

Click on the link below for tools and information when making advance directives.

Advance Directives Flyer, PDF

Looking for help?

Contact Us

If you have questions, find the number you need to get help and support.

Find a doctor

Find a doctor, hospital, or pharmacy.

Documents & forms

Find the documents and forms you need, including your Member Handbook.