The resources below give healthcare providers information about the types of Medicare Advantage plans Humana offers for individual Medicare beneficiaries. These include operational and reimbursement guidelines, provider qualifications and requirements, frequently asked questions and other information.

The provider materials below are for the 2019 plan year.

2019 Humana Medicare Advantage Health Maintenance Organization (HMO) plan

The following documents contain information on HMO and HMO point-of-service (HMO-POS) plans and HMO Special Needs Plans (SNPs).

HMO electronic claims flyer, PDF opens new window

HMO FAQs, PDF opens new window

2019 Humana Medicare Advantage Preferred Provider Organization (PPO) Plan

2019 Humana Medicare Advantage full and partial networks private-fee-for-service (PFFS) plans

Medicare Advantage Rules of Participation

Other Medicare Advantage resources

Below are two programs to which Humana Medicare Advantage members may have access as part of their plan.

SilverSneakers® fitness program, PDF opens new window

Humana Well Dine® food program,opens new window

Medicare supplement insurance

This document explains Medicare supplement insurance (also known as Medigap) basics. It includes a chart of the standard Medicare supplement plans.

Medicare supplement insurance plans, PDF opens new window

Medicare Outpatient Observation Notice (MOON)

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 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), passed on Aug. 6, 2015.

Important notes:

  • The MOON may be delivered before a beneficiary receives 24 hours of observation services as an outpatient
  • If the beneficiary is transferred, discharged or admitted, the MOON still must be delivered no later than 36 hours following initiation of observation services
  • The start time of observation services is measured as the clock time observation services are initiated in accordance with a physician’s order

Hospitals and CAHs must use one of the following Office of Management and Budget (OMB)-approved MOONs, which can be downloaded on the Centers for Medicare & Medicaid Services (CMS) website:

Beneficiary Notices Initiative (BNI) for Moon, opens new window

Instructions on how to fill out CR9935 MOON, PDF opens new window

Additional information about CR9935 Moon, PDF opens new window