Humana offers a variety of programs for patients who need care for complex medical situations or support for chronic conditions. Through these programs, care managers collaborate with physicians and other healthcare professionals to help patients manage their healthcare needs while addressing their physical, behavioral, cognitive, social and financial needs.
Patients who enroll in a Humana care management program are supported by a care manager. The manager's goal is to anticipate the patient’s needs and problems, encourage preventive care and prevent costly interventions through evaluations of medical, functional and psychosocial status.
Services may include:
- Telephone outreach
- Personalized health education, guidance and condition support
- Printed and electronic educational materials
- Social services support via telephone referral to community resources
- Physician review and consultation by medical officers and/or clinical pharmacists
- Nutrition guidance
- Self-care management coaching and coping skills
- Reinforcement of the treating physician’s plan of care
- Medication adherence monitoring and awareness of patient’s pharmacy benefit design
- Referral to benefits and resources as needed by each patient
- Coordination of care with healthcare providers
Humana's predictive modeling tools and assessment processes identify eligible patients based on their gaps in care and potential health. Care management programs are available to eligible members of commercial self-funded groups for an additional fee. These programs are automatically included for commercial fully insured and Group Medicare groups at no additional cost as part of their benefit plan (some exclusions apply). Patients can opt out of the programs at any time by notifying their care manager of their wishes.
Services are available for select Medicare, Medicaid, commercial, healthcare exchange and administrative services only patients in all markets, except Puerto Rico.
These programs and tools are not insurance products and are not guaranteed under any contract. Humana is not required to provide these services but makes them available to eligible patients.
One of the chronic care programs we offer Medicare members accept referrals directly from physicians. Humana At Home care management helps your Humana-covered patients remain independent at home. Humana provides care management to patients who qualify and are at risk of frequent hospitalization.
To make a referral, please complete the Humana At Home referral request form below. Then, submit it in one of these ways:
- Fill out the form, scan it and save it using the patient’s Humana ID number as the file name. Send the file to us via secure email. Standard email is not secure and may expose information to unauthorized parties. To send an email, please , opens new window; then email us at this address: HAH_ProviderReferrals@humana.com.
- Fax the completed form, with a cover sheet, to 877-770-0651.
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If your patient meets the criteria for Humana at Home, one of our referral specialists will attempt to contact him or her for enrollment in the service. Once the patient agrees to participate, a care manager will outreach them to help oversee his or her healthcare needs.
Our triage associate will notify you of our decision within three business days of receiving your referral request. Please include your email address and/or telephone number (with extension) on the referral form so that triage can contact you.
If you have questions, please email triage directly at HAH_triage@humana.com, and a representative will be glad to assist you.