Humana Fully Integrated D-SNP
Find the documents and forms you need to get the most out of your Humana Fully Integrated D-SNP enrollment.
Caregiver’s Toolkit – English
Caregiver’s Toolkit – Spanish
Annual Notice of Change (ANOC)
Annual Notice of Change – Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP)
Notificación anual de cambios – Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP)
Annual Notice of Change – Humana Dual Fully Integrated H2875-003 (HMO D-SNP)
Notificación anual de cambios – Humana Dual Fully Integrated H2875-003 (HMO D-SNP)
Evidence of coverage
Your 2026 Evidence of Coverage – Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP)
Su Evidencia de Cobertura 2026 – Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP)
Your 2026 Evidence of Coverage – Humana Gold Plus SNP-DE H2875-002 (HMO D-SNP)
Su Evidencia de Cobertura 2026 – Humana Gold Plus SNP-DE H2875-002 (HMO D-SNP)
Your 2026 Evidence of Coverage – Humana Dual Fully Integrated H2875-003 (HMO D-SNP)
Su Evidencia de Cobertura 2026 – Humana Dual Fully Integrated H2875-003 (HMO D-SNP)
Your 2026 Evidence of Coverage – Humana Gold Plus SNP-DE H2875-004 (HMO D-SNP)
Su Evidencia de Cobertura 2026 – Humana Gold Plus SNP-DE H2875-004 (HMO D-SNP)
Your 2026 Evidence of Coverage – Humana Dual Select H2875-005 (HMO D-SNP)
Su Evidencia de Cobertura 2026 – Humana Dual Select H2875-005 (HMO D-SNP)
Your 2026 Evidence of Coverage - Humana Dual Select H2875-006 (HMO-POS D-SNP)
Su Evidencia de Cobertura 2026 - Humana Dual Select H2875-006 (HMO-POS D-SNP)
Pharmacy documents
Over-the-Counter Order Form – English
Over-the-Counter Order Form – Spanish
Pharmacy Direct Member Reimbursement Form
2025 Prescription Drug Guide (HMO D-SNP) – English
2025 Prescription Drug Guide (HMO D-SNP) – Spanish
2025 Prescription Drug Guide (HMO-POS D-SNP) – English
2025 Prescription Drug Guide (HMO-POS D-SNP) – Spanish
2026 Prescription Drug Guide (HMO-POS D-SNP) (HMO D-SNP) – English
2026 Prescription Drug Guide (HMO-POS D-SNP) (HMO D-SNP) – Spanish
2025 Prior Authorization Criteria
2026 Prior Authorization Criteria
2025 Step Therapy Criteria
2026 Step Therapy Criteria
2025 D-SNP Transition Policy
2026 D-SNP Transition Policy
Prior authorization forms
Provider directory
You can search for a provider near you using our Find Care
View a printable PDF of your provider directory
Summary of Benefits
Summary of Benefits – Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP)
Resumen de beneficios – Humana Dual Fully Integrated H2875-001 (HMO-POS D-SNP)
Summary of Benefits – Humana Dual Fully Integrated H2875-003 (HMO D-SNP)
Resumen de beneficios – Humana Dual Fully Integrated H2875-003 (HMO D-SNP)
Humana Healthy Horizons in Virginia
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