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Medicare and Medicaid information

This webpage offers publications and other information for healthcare professionals who treat patients with Humana Medicare, Medicaid and dual Medicare-Medicaid coverage.

Doctor examining senior female patient


Medicare private-fee-for-service (PFFS)

Terms and conditions for Medicare PFFS

Medicare PFFS , PDF opens in new window

Medicare Advantage materials

Operational and reimbursement guidelines, provider qualifications and requirements, frequently asked questions and other information

Medicare Advantage materials

Medicaid and dual Medicare-Medicaid provider materials

State-specific resources for Humana Healthy Horizons (Medicaid) products

Humana Healthy Horizons™ in Florida (medical and long-term care plans)

Humana Healthy Horizons™ in Kentucky

Humana Healthy Horizons™ in South Carolina

State-specific resources for Humana Gold-Plus Integrated (dual Medicare-Medicaid) products

Illinois Medicare-Medicaid

Provider manuals

Florida materials

2021 Humana Healthy Horizons in Florida Provider Handbook , PDF opens in new window

Illinois materials

2021 Illinois-CMS-sponsored Medicare-Medicaid Alignment Initiative (Demonstration) Manual , PDF opens in new window

Kentucky materials

2021 Humana Healthy Horizons in Kentucky Provider Manual , PDF opens in new window

South Carolina materials

2021 Humana Healthy Horizons in South Carolina Provider Manual , PDF opens in new window

Other resources

National coverage determinations

Learn about the latest changes the Centers for Medicare & Medicaid Services (CMS) has made to services that are covered by Medicare.

National coverage determinations

Special needs plans presentation

Learn about the special needs plans (SNPs) we offer in select states and the critical role you play in the care of our SNP members.

Special needs plan presentation 2021, opens new window

Quality materials

Visit our quality resources page for information on CMS Star Ratings, the Healthcare Effectiveness Data and Information Set (HEDIS®), the Consumer Assessment of Healthcare Providers and Systems (CAHPS®), the CMS Health Outcomes Survey (HOS) and more.

Quality materials