These documents and resources apply to all counties in Kentucky.
Access material health documents and resources
Provider manual
2023 Humana Healthy Horizons in Kentucky provider manual – effective March 15, 2023, PDF
2022 Humana Healthy Horizons in Kentucky provider manual – effective June 16, 2022, PDF
Resource, reference, and billing guides
Humana Healthy Horizons in Kentucky Provider Resource Guide, PDF
Provider Resource Guide – Transition Details, PDF
Enrollee Handbook
2023 Humana Healthy Horizons in Kentucky Enrollee Handbook, PDF
Access our online Find a Doctor service
Additional information
Behavioral health after-hours availability information, PDF
Medicaid Prior Authorization and Notification List, PDF
Non-discrimination, cultural competency, language proficiency, and Americans with Disabilities Act (ADA) information, PDF
Preauthorization for advanced imaging services, PDF
Primary care provider and specialist after-hours availability information, PDF
Evidence-based practice surveys
Evidence-based practice survey for non-group providers
Evidence-based practice survey for group/facility providers
Pharmacy resources
MedImpact is the pharmacy benefit manager (PBM) for all pharmacy claims processing and pharmacy prior authorizations (PAs).
All outpatient drugs, including over-the-counter drugs, are covered under a single Kentucky Preferred Drug List (PDL), also known as a formulary, managed by MedImpact. This does not include physician-administered drugs, which continue to be managed under our enrollees’ medical benefit.
View a list of preferred drugs covered under the KY PDL, PDF.
MedImpact manages all PAs. To submit a PA request:
- Call MedImpact at 844-336-2676
- Fax 858-357-2612
- Use the CoverMyMeds®, Surescripts®, or CenterX® ePA online portals
For all medically billed drug (J-code) PA requests, please continue to send those directly to us for review.
Please submit to Humana Healthy Horizons® in Kentucky all claims with a date of service prior to July 1, 2021.
Please submit to MedImpact all claims with a date of service on and after July 1, 2021.
Please use the Kentucky Medicaid Pharmacy Prior Authorization Form, PDF when submitting a PA request.
For pharmacy and therapeutics, go to Pharmacy and therapeutics information and select the “Committees” drop-down menu and then select “P&T.”
Kentucky Medicaid Maximum Quantity List, PDF
Kentucky Medicaid Single Preferred Drug List, PDF
Kentucky Medicaid Single PDL Prior Authorization Criteria, PDF
Pharmacy Quick Reference Guide, PDF
Preferred Drug List
Over-the-counter drug list, PDF
Forms
Claim Dispute Form, PDF
Hospice Consent Form, PDF
Hysterectomy Consent Form, PDF
Incarceration Status Correction Form, PDF
Notification of Pregnancy Form, PDF
Provider Grievance Form, PDF
Referral to Medicaid Case Management Form, PDF
Use the below sample coordination of care letter when providing behavioral health updates to primary care physicians.
Sample coordination of care letter, PDF
Vida Health offers free personalized health coaching to our enrollees 18 or older who have type 2 diabetes and who are not currently working with a Humana Care coach.
Through Vida Health, eligible enrollees can:
- Choose their own Vida Health coach (e.g., nutritionist, diabetes educator, etc.)
- Monitor their health progress
- Use video, phone or text to visit with their health coach
- View tips and videos customized to their health needs
Visit Vida Health, opens new window to learn more. You also can call 855-910-1215 (TTY: 711) to refer a patient you believe could benefit from this program.
Kentucky Medicaid Diabetic Supplies Preferred Product List, PDF opens new window
Our enrollees can connect with doctors 24 hours a day, 7 days a week via virtual visits with MDLIVE®. All MDLIVE doctors are state-licensed, board-certified experts attending patients virtually.
While enrollees can access this service, we reiterate that there are instances when they should receive in-person care from their primary care physician and/or a specialist, and when a visit to a retail clinic, urgent care center, or emergency room (ER) is needed.
MDLIVE provides consultation and treatment for a variety of healthcare needs, including cold and flu symptoms, medication adjustments, prescription refills, and skin conditions, without having to see anyone in person.
To get care via MDLIVE, our enrollees can:
- Go to MDLIVE, opens new window*, create an account, and connect with a doctor
- Call 844-403-0556 (TTY: 711), 24 hours a day, 7 days a week
- Download* the MDLIVE mobile app from the App Store® or Google Play®
For more information about MDLIVE, please visit Humana.com/KentuckyVirtualCare, opens new window.
*Internet access required
