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.
Humana Care Management programs include telephonic care coordination for:
- Humana Care Support: high-risk members in Medicare Advantage plans
- Special Needs Plans (SNP): members in C-SNP and D-SNP plans
- Illinois Medicare Medicaid Plans (MMP): Medicare/Medicaid members in Illinois
- Behavioral Healthcare Coordination and Consulting: Medicare-covered patients whose plans include this service.
Humana Care Management supports patients with medical, behavioral health and social determinants of health issues, such as food insecurity, social isolation, loneliness, transportation and housing instability.
Humana's predictive modeling tools and assessment process identify eligible patients based on their disabilities, comorbidities and chronic care management needs.
Case management and chronic care programs are available to eligible patients as part of their benefit plan and at no additional cost. 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.
Humana Care Management accepts referrals directly from physicians for eligible members.
To make a referral, please complete the Humana Care Management referral request form below. Then, submit it in one of these ways:
If your patient meets the criteria for Humana Care Management, 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.
You will receive acknowledgement of receipt of your referral via the email provided. If your patient meets the criteria for Humana Care Management, 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 reach out to them to help oversee his or her healthcare needs.