Members who choose to enroll in a Humana case management or chronic care program are assigned a care manager who supports them by phone (eligible members also receive home visits). The manager's goal is to anticipate members' 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:
Some chronic conditions addressed by our programs include chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease, hypertension, HIV/AIDS, asthma and diabetes.
Humana's predictive modeling tools and assessment process identify eligible members based on their disabilities, comorbidities and chronic care management needs. Case management and chronic care programs are available to eligible members as part of their benefit plan and at no additional cost. Members can opt out of the programs at any time by notifying their care manager of their wishes.
Services are available for select Medicare, Medicaid, commercial, health care exchange and administrative-services-only members in all markets, except Puerto Rico.
For more information about our case management and chronic care offerings and to verify for which programs a member may be eligible, please call Humana Health Planning and Support at 1-800-491-4164. Representatives are available to take your call Monday through Friday from 8:30 a.m. to 5 p.m. local time. This line is available for anyone who wishes to refer a Humana member to a care management program, including physicians, social workers, hospital staff, caregivers or members themselves.
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 members.