Medicare Provider Materials

Humana offers Medicare Advantage (MA) plans for individual Medicare beneficiaries and for employer group Medicare benefits. The resources below give provider-specific information about the types of Medicare Advantage plans, including operational and reimbursement guidelines, provider qualifications and requirements, frequently asked questions, and other information about Humana health benefits for seniors.

The provider materials below are for the 2013 plan year followed by the documents for the 2012 plan year. The 2012 materials will be removed in February 2013.

2013 Humana MA Health Maintenance Organization (HMO) Plan

The following documents contain information on HMO, HMO-Point-of-Service (HMO-POS) and HMO SNP (special needs) plans.

HMO Electronic Claims Flier
(234 KB) Download PDF
English

HMO Frequently Asked Questions
(3.69 MB) Download PDF
English

2013 Humana MA Preferred Provider Organization (PPO) Plan

PPO Electronic Claims Flier
(236 KB) Download PDF
English

PPO Frequently Asked Questions
(2.55 MB) Download PDF
English

2013 Humana MA Non-network Private Fee-for-Service (PFFS) Plan

Non-network PFFS Electronic Claims Flier
(208 KB)
English

Non-network PFFS Frequently Asked Questions
(4.33 MB)
English

Non-network Reimbursement Methodology
(3.04 MB)
English

2013 PFFS Terms and Conditions of Payment
Humana Gold Choice (PFFS)

2013 Humana MA Network PFFS Plan

Network PFFS Electronic Claims Flier
(193 KB) Download PDF
English

Network PFFS Frequently Asked Questions
(4.04 MB) Download PDF
English

Provider and Medicare Beneficiary Need to Know Flier
(134 KB) Download PDF
English

Other Medicare Materials

Information in the following documents covers programs and services that support Humana Medicare-participating providers and members.

What is Medicare Risk Adjustment (MRA)?
(75 KB) Download PDF
English

SilverSneakers® Fitness Program
(1.58 MB) Download PDF
English

Provider Notice Regarding Influenza Pandemic Emergency
(20 KB) Download Document
English

Humana's Well Dine Food Program
Well Dine Food Program