2021 Humana Medicare Advantage Health Maintenance Organization (HMO) plan
The following documents contain information about HMO and HMO point-of-service (HMO-POS) plans and HMO Special Needs Plans (SNPs).
Humana’s priority during the coronavirus disease 2019 (COVID-19) outbreak is to support the safety and well-being of the patients and communities we serve. For more information, visit Humana.com/provider/coronavirus.
The resources below give healthcare providers information about the types of Medicare Advantage plans Humana offers for individual Medicare beneficiaries. Included are operational and reimbursement guidelines, details about provider qualifications and requirements, frequently asked questions and other information.
The materials are for the 2021 plan year.
The following documents contain information about HMO and HMO point-of-service (HMO-POS) plans and HMO Special Needs Plans (SNPs).
Full and partial networks PFFS electronic claims flyer, PDF opens new window
Full and partial networks PFFS FAQs, PDF opens new window
Medicare Advantage PFFS plan model terms and conditions of payment, PDF opens new window
Below are two programs to which Humana Medicare Advantage members may have access as part of their plan.
This document explains Medicare supplement insurance (also known as Medigap) basics. It includes a chart of the standard Medicare supplement plans.
When a Medicare beneficiary receives outpatient observation services from a hospital or critical access hospital (CAH) for more than 24 hours, he or she (or the beneficiary’s authorized representative) must receive a Medicare Outpatient Observation Notice (MOON). The written MOON and a verbal explanation of the notice must be delivered no later than 36 hours after services were initiated. The MOON is mandated by the Federal Notice of Observation Treatment and Implication for Care Eligibility Act (NOTICE Act), enacted on Aug. 6, 2015.
Important notes:
Hospitals and CAHs must use the Office of Management and Budget (OMB)-approved MOON form, which can be downloaded from the Centers for Medicare & Medicaid Services (CMS) website , opens new window: