Medicare and Medicaid information

This Web page offers publications and other information for health care providers who serve Humana Medicare, Medicaid and dual Medicare-Medicaid members.

Provider publications

Medicare private fee-for-service (PFFS) terms and conditions - English (237 Kb)

Medicare provider materials – Operational and reimbursement guidelines, provider qualifications and requirements, frequently asked questions and electronic claims information.

Medicaid and dual Medicare-Medicaid provider materials – State-specific provider resources for Humana’s Medicaid and dual Medicare-Medicaid products.

Medicaid appendices

Illinois joint CMS-State sponsored Medicare Medicaid Alignment Initiative ("Demonstration") and Illinois Integrated Care Program (ICP) Appendix - English (381 Kb)

Virginia Commonwealth Coordinated Care Appendix - English (288 Kb)

Florida Medicaid Managed Medical Assistance (MMMA) Appendix to Humana's Provider Handbook - English (320 Kb)

Other resources

Routine physical exams for Medicare members: Learn about annual coverage for these exams.

Quality materials: Visit our quality resources Web page for information on Centers for Medicare & Medicaid Services Star ratings, the Healthcare Effectiveness Data and Information Set (HEDIS), the Consumer Assessment of Healthcare Providers and Systems (CAHPS) and the CMS Health Outcomes Survey (HOS) and more.