Get the care you deserve. Find information about authorizations, Extra Help and more.
Your rights and responsibilities
The rights and responsibilities statement reminds members and healthcare providers of their roles in maintaining a productive relationship.
Medical Authorizations
Find out if your doctor or hospital needs advanced approval to cover costs for certain medical procedures, services, or medications.
Pharmacy authorizations
Before filling a prescription for some medications, you may have to get approval from Humana to make sure the medication is covered under your plan.
Disenrollment and cancellation
Discover when and how to cancel or disenroll from your Humana Medicare Advantage or prescription drug plan.
Exceptions and appeals
Find answers to your questions and concerns about filing an exception, appeal or grievance and appointing a representative.
Medical organization determination
You have the right to ask Humana to pay for items or services you think should be covered. If you are a Medicare member, this is called a request for an organization determination.
Extra Help
You may be eligible for Extra Help with payments for your prescription drug plan, deductible and copayments. Access forms online.
Protections against surprise billing
Learn your rights and protections against surprise medical bills and balance billing.
New medical technology
Humana follows strict guidelines to make sure the care you are getting is clinically sound and of your best interest.
Utilization Management
Utilization management is used to determine whether a service or treatment is medically necessary and appropriate for payment under your benefit plan. Humana does not reward or provide financial incentives to doctors, other individuals or Humana employees for denying coverage or encouraging under use of service.
If you have questions or concerns related to UM, staff are available at least eight hours a day during normal business hours.
If you have questions or disagree with a coverage decision, call Member Service at the number on your ID card.