About Humana Healthy Horizons in Kentucky

Humana Healthy Horizons™ in Kentucky is more than a health plan. We are committed to providing what you need to give our enrollees the best care possible. Humana Healthy Horizons features great medical benefits and more, including our Go365 for Humana Healthy Horizons™ rewards program, expanded vision services and childcare assistance, and helpful digital tools will help enrollees better manage their health.

Humana contracted with the Kentucky Cabinet for Health and Family Services to provide services to Medicaid enrollees through Humana Healthy Horizons. Medicaid provides healthcare coverage for income-eligible children, seniors, disabled adults, pregnant women, and other eligible adults. It is funded by both the state and federal governments.

Humana medical coverage policies are available on Humana.com, opens new window. Humana uses nationally recognized medical necessity guidelines (e.g., Milliman Care Guidelines [MCG] and American Society of Addiction Medicine® criteria). Criteria are readily available for review by the Kentucky Department for Medicaid Services (DMS), practitioners, the public, or enrollees on request at no cost. MCG guidelines are available either verbally or in writing for Kentucky DMS, practitioners, the public, or enrollees on request. For providers and practitioners, the process to obtain criteria is communicated annually in the provider newsletter and in the provider manual.

Reminders

The Kentucky Department for Medicaid Services (KDMS) has issued prior authorization guidance.

Learn more about the KDMS guidance, PDF opens new window

The COVID-19 pandemic has caused enrollees to delay many elective procedures, including certain cancer screenings (e.g., colorectal cancer). Please talk to your patients about health screenings, for cancer or otherwise, that may be overdue as well as safety protocols your facility has in place.

Eligible enrollees 5 and older can earn $40 in rewards through Go365 for Humana Healthy Horizons after submitting proof of getting a COVID-19 vaccination. Learn more about the COVID-19 reward, opens new window.

Don’t forget that well-being visits can be done in-person or during a telemedicine visit. Feel free to pass along a reminder to your patient’s caregivers if you offer this service. Many well-being visits and screenings were delayed as a result of the COVID-19 pandemic. If a patient has an overdue screening or visit, please reach out about rescheduling.

As of Jan. 1, 2021, qualifying enrollees with type 2 diabetes can work with a health coach through Vida Health. Visit Vida Health, opens new window or call 855-910-1215 (TTY: 711) to learn more. To refer a patient you believe could benefit from this program, call 855-910-1215 (TTY: 711).