Humana Member Guidelines

Document created by humanaadmin3 Moderator on Aug 3, 2018
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Guidelines for Humana members

Know your rights and understand your plan and costs, including authorizations, exceptions, and appeals.



Member rights

Your rights and responsibilities

Humana’s member rights and responsibilities statement explains your role and your physician’s, so you can work together productively.

Insurance Through Employer Member Rights - Humana Customer Support



Important Member Information

How to use your health benefits: A guide for Humana members

Get the most from your Humana healthcare plan with this comprehensive and easy-to-follow guide to health insurance benefits.


MyHumana Registration for Coverage Through Employers


Exceptions and appeals

Get help with an exception, grievance, or appeal

Ask for a prescription drug coverage exception. Or file a grievance or appeal.

You can also appoint a representative to act on your behalf.

Drug Coverage Determinat

ion - Humana Group Health Customer Support 


Medical authorizations

If you need advance approval

For some procedures and services, your doctor or hospital needs to get advance approval before your plan covers any costs. This step is called "preauthorization" or "notification."



Medical Authorizations - Humana Group Health Customer Support



Pharmacy authorizations

Make sure your prescriptions are covered

Certain prescription drugs require prior authorization or a medical exception for coverage. If your drug requires this step, your doctor will need to request and receive approval from Humana before the drug may be covered under your insurance plan.

MyHumana Registration for Coverage Through Employers