Help

How do I?

Need to find a doctor or make sure your prescriptions are covered? The information below will help answer questions you may have.

How do I find a Doctor?

To find out which region in which you reside, please see the link below for your county.

Provider Directories:

How do I know if my prescriptions are covered?

You can click on our Prescription Drug Guide below, or call Humana Gold Plus Integrated at 1-855-280-4002, TTY: 711 , 8 a.m – 8 p.m., Monday – Friday. The call is free.

What if I need transportation?

LogistiCare manages routine medical transportation for the Humana Gold Plus Integrated, A Commonwealth Coordinated Care Plan (Medicare-Medicaid Plan). Routine medical transportation is designed to help you get to health care visits, including, but not limited to:

  • Trips to nursing homes
  • Trips to the pharmacy right after doctor visits
  • Other approved medical providers and locations
  • Medical appointments
  • Ongoing care, such as dialysis

Give us a call! A LogistiCare professional will gladly help.

To make a reservation, call 1-855-253-6869

Monday through Friday, 8 a.m. to 5 p.m.

Use this number for reservations to and from a facility.

TTY: 1-866-288-3133

For emergency transportation services, call 911.

How do I enroll?

Enrollment in Humana Gold Plus Integrated is done through Virginia's enrollment broker. To see if you are eligible, call the Virginia Coordinated Care HelpLine, at 1-855-889-5243 (TTY: 1-800-817-6608), 8:30 a.m – 6 p.m., Monday – Friday. The call is free.

To visit the enrollment broker website, click here (link opens in new window) 

What are My Rights and Responsibilities if I decide I no longer want the Humana Gold Plus Integrated Plan?

Information on Requesting a Coverage Determination or Fast Coverage Determination

A coverage decision is an initial decision we make about your benefits and coverage or about the amount we will pay for your medical services, items, or drugs. We are making a coverage decision whenever we decide what is covered for you and how much we pay.

To learn more about the procedures for filing an organization/coverage determination click here.

To request a Coverage Determination, please complete the CMS Model Coverage Determination Request form (link opens in new window) 

Grievances and Appeals

If you would like to learn more about filing a grievance or appeal with Humana, please click here

To file a grievance or appeal with CMS, please complete the CMS form by clicking Medicare Complaint Form (link opens in new window) 

How do I name someone who will represent me and be my advocate with the state and Humana?

If you are having trouble with understanding your benefits, would like to appoint a person to file a grievance, request a coverage determination, or request an appeal on your behalf, you and the person accepting the appointment must fill out this form (or a written equivalent) and submit it with the request. Your doctor or other provider may request a coverage determination, redetermination or independent review entity (IRE) reconsideration on the enrollee's behalf without having to be an appointed representative.

Appoint a Representative form (link opens in new window)