humana cares

Humana case management and chronic care programs

Humana offers a variety of programs for patients who need care for complex medical situations or support for chronic conditions. Through these programs, care managers collaborate with physicians and other health care professionals to help patients continue to live at home safely while addressing their physical, behavioral, cognitive, social and financial needs.

Overview of programs

Humana-covered patients who choose to enroll in a Humana case management or chronic care program are assigned a care manager who supports them by phone. Eligible patients also receive home visits. The manager's goal is to anticipate patients' needs and problems, encourage preventive care and prevent costly interventions through home-safety assessments and evaluations of medical, functional and psychosocial status.

Services may include:

  • Facilitating conference calls between the patient, the physician and the care manager as needed to clarify treatment plans, medication regimens or other urgent issues
  • Monitoring medication adherence
  • Assessing the patient's daily living activities and cognitive, behavioral and social support
  • Assessing the patient's risk for falls and providing fall-prevention education
  • Connecting patients and their families with professionals who can help them address medical, legal, housing, insurance and financial issues facing older adults
  • Helping caregivers access support and respite care
  • Arranging access to transportation
  • Assisting patients in obtaining home health and durable medical equipment
  • Referring patients to meal-delivery programs and advance directive preparation services

Some chronic conditions addressed by our programs include chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease, hypertension, HIV/AIDS, asthma and diabetes.

Eligibility and Cost

Humana's predictive modeling tools and assessment process identify eligible Humana-covered patients based on their disabilities, comorbidities and chronic care management needs. Case management and chronic care programs are available to eligible patients as part of their benefit plan and at no additional cost. Patients can opt out of the programs at any time by notifying their care manager of their wishes.

Services are available for select patients with Humana Medicare, Medicaid, commercial, health care exchange and administrative-services-only coverage in all markets, except Puerto Rico.

These programs and tools are not insurance products and are not guaranteed under any contract. Humana is not required to provide these services, but makes them available to eligible patients.

Referrals from physicians

One of the chronic care programs we offer accepts referrals directly from physicians. Humana At Home care management helps your Humana-covered patients remain independent at home. Humana provides a personal care manager to patients who qualify and are at risk of frequent hospitalization.

To make a referral, please complete the Humana At Home referral request form below. Then, submit it in one of these ways:

  • Fill out the form, scan it and save it using the patient’s Humana ID number as the file name. Send the file via secure email to HAH_ProviderReferrals@humana.com.
  • Fax the completed form, with a cover sheet, to 1-877-770-0651.

Humana at Home provider request form (PDF opens in new window)

If your patient meets the criteria for Humana at Home, one of our referral specialists will attempt to contact him or her for enrollment in the service. Once the patient agrees to participate, the patient will be placed with a care manager to help oversee his or her healthcare needs.

Our triage associate will notify you of our decision within three business days of receiving your referral request. Please include your email address and/or telephone number (with extension) on the referral form so that triage can contact you.

If you have questions, please email triage directly at HAH_triage@humana.com, and a representative will be glad to assist you.