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, childcare assistance, and helpful digital tools to help enrollees better manage their health.
Humana contracts 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 , 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 Kentucky Department for Medicaid Services (Kentucky DMS), practitioners, the public, or enrollees on request at no cost. MCG guidelines are available either verbally or in writing on request. For providers and practitioners, the process to obtain criteria is communicated annually in the provider newsletter and provider manual.
The Kentucky Cabinet for Health and Family Services (CHFS) is inviting Home Health Care Services (HHCS) providers to join us for a virtual town hall series discussing the implementation of electronic visit verification (EVV). The town halls are being held every Wednesday from 1-2:30 p.m. Eastern / 12-1:30 p.m. Central through the end of the year.
The state has contracted with Therap Services as our selected vendor for EVV HHCS. The town halls are an opportunity to learn more about the Therap EVV system, get information on onboarding and implementation, and ask questions. To register, use the link below.
Register for EVV HHCS Town Hall
Past town halls are available for viewing on Therap’s Kentucky EVV website
We hope you can join us to prepare your agency for the coming launch
Kentucky DMS has issued updated prior authorization guidance.
Review prior authorization guidance
The COVID-19 pandemic caused enrollees to delay many elective procedures, including certain cancer screenings (e.g., colonoscopies). Please talk to your patients about health screenings that may be overdue as well as safety protocols your facility has in place.
Eligible enrollees 6 months old and older can earn $40 in rewards through Go365 for Humana Healthy Horizons® after submitting proof of a COVID-19 vaccination. , opens new window.
Don’t forget that well-being visits can occur in-person or during a telemedicine visit. Feel free to pass along a reminder to your patients’ caregivers if you offer this service. Many well-being visits and screenings were delayed due to the COVID-19 pandemic. If a patient has an overdue screening or visit, please try to reschedule.
Qualifying enrollees with type 2 diabetes can work with a health coach through Vida Health. Visit , 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).