South Carolina Dual Integrated Special Needs Plan

Documents and Forms

Find the documents and forms you need to get the most out of your Humana D-SNP enrollment.

Senior playing sports with child outdoors being active

Member Handbook

2026 Member Handbook - Humana Dual Integrated Special Needs Plan (HMO-POS D-SNP) pdf opens in new window

Manual para Afiliados 2026 - Humana Dual Integrated Special Needs Plan (HMO-POS D-SNP) pdf opens in new window

Summary of Benefits - Humana Dual Integrated (HMO D-SNP) pdf opens in new window

Resumen de Beneficios - Humana Dual Integrated (HMO D-SNP) pdf opens in new window

Annual Notice of Changes (ANOC) - Humana Dual Integrated (HMO D-SNP) H1396-001 pdf opens in new window

Notificación Anual de Cambios - Humana Dual Integrated (HMO D-SNP) H1396-001 pdf opens in new window

Pharmacy documents

Over-the-Counter Order Form - English pdf opens in new window

Over-the-Counter Order Form - Spanish pdf opens in new window

Pharmacy Direct Member Reimbursement Form pdf opens in new window

2026 Humana Drug List (HMO-POS D-SNP) - English pdf opens in new window

2026 Humana Drug List (HMO-POS D-SNP) - Spanish 2026 pdf opens in new window

2026 Step Therapy Criteria pdf opens in new window

DSNP Transition Policy opens in new window

Prior authorization forms

Medical and pharmacy authorizations opens in new window

Provider and pharmacy directory

You can search for a provider near you using our Find Care opens in new window tool.

View a printable PDF of your provider directory

Humana Healthy Horizons in South Carolina

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. We also provide free language interpreter services. See our full accessibility rights information , non-discrimination disclosure , and language options .

If you are requesting membership in a Dual Eligible Special Needs Plan (D-SNP), the following statement applies: I understand this plan is for individuals with both Medicaid and Medicare. My ability to enroll is based on verification that I am entitled to both Medicare and medical assistance under Medicaid.

Medicare beneficiaries may also enroll in Humana Medicare plans through the CMS Medicare Online Enrollment Center located at https://www.medicare.gov opens in new window .

Our health benefit plans have exclusions and limitations and terms under which the coverage may be continued in force or discontinued. For costs and complete details of the coverage, refer to the plan document or call or write your Humana insurance agent or the company. In the event of any disagreement between this communication and the plan document, the plan document will control.

Other pharmacies may be available in our network. You can locate network pharmacies by visiting Humana.com/finder/pharmacy. CenterWell Pharmacy is the preferred cost-sharing mail-order pharmacy under many Humana MAPD and PDP plans. There are other pharmacies, including preferred cost-sharing retail pharmacies, are available in our network. Members can choose any network pharmacy for their prescriptions.

Humana is a Dual Eligible Special Needs plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in any Humana plan depends on contract renewal.

© Humana 2025

SCHMSSVEN

Last Updated: 8/21/2025