Provider documents and resources

Important Documents

2021 Humana Healthy Horizons in South Carolina Provider Manual, PDF

2022 Humana Healthy Horizons in South Carolina Member Handbook, PDF

2022 Humana Healthy Horizons in South Carolina Provider Resource Guide, PDF

2022 Humana Healthy Horizons in South Carolina Social Determinants of Health Resource Guide, PDF

Humana Healthy Horizons in South Carolina Prior Authorization Request Form, PDF

Pharmacy Resources

Diabetic Testing Supplies Flyer, PDF

Provider Common Preferred Drug List, PDF

Humana Health and Wellness Catalog and Order Form – English, PDF

Humana Health and Wellness Catalog and Order Form – Spanish, PDF

2021 Prescription Drug List – English, PDF

2021 Prescription Drug List – Spanish, PDF

2022 Prescription Drug List – English, PDF

2022 Prescription Drug List – Spanish, PDF

Summary of Preferred Drug List Changes – English, PDF

Summary of Preferred Drug List Changes – Spanish, PDF

OB-GYN provider documents

Abortion Statement, PDF

Consent for Sterilization, PDF

Notification of Pregnancy Form, PDF

Surgical Justification Review for Hysterectomy Patient, PDF

Go365 for Humana Healthy Horizons™

Members can register for the new Go365 for Humana Healthy Horizons wellness program and earn rewards for participating in healthy activities.

To earn rewards, members must:

  • Download the Go365 for Humana Healthy Horizons app onto a mobile device from the Apple App Store or Google Play.
  • Create an account to access and engage in the program.
    • Members younger than 18 must have a parent or guardian register on their behalf using the minor’s Medicaid member ID.
    • Members 18 or older can register and create their own Go365 accounts. They must have their Medicaid member IDs to register.

Members can use the same login information from MyHumana account to access Go365 for Humana Healthy Horizons.

For each eligible completed Go365 activity, members earn rewards that can be redeemed in the Go365 in-app mall. Rewards earned through Go365 are not transferrable to other managed care plans or other programs. Rewards are non-transferable and have no cash value.

Earned e-gift cards may not be used for tobacco, alcohol, firearms, lottery tickets or other items not supporting a healthy lifestyle.

For full program details, please refer to the 2021 Humana Healthy Horizons in South Carolina Provider Manual, PDF