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As used in connection with insurance products and services, “Humana” is the brand name for insurance products and services provided by one or more of the Humana group of insurer and health plan subsidiary and affiliate companies (each, a “Humana Ins. Sub.”). Insurance products and services are solely and only provided by the one or more Humana Ins. Subs. specified on the insurance policy, not Humana Inc. Not all insurance products and services are available in each state.

Humana is a Medicare Advantage HMO, PPO and PFFS organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any Humana plan depends on contract renewal.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender, gender identity, ancestry, ethnicity, marital status, religion or language. We also provide free language interpreter services. See our full accessibility rights information, non-discrimination disclosure, and language options.

Please note, any information listed under a provider's practice focus has been supplied by the provider and has not been validated.

Other providers are available in our network.

Some plans require you to obtain a referral from your Primary Care Provider (PCP), or prior authorization from the plan, before receiving certain services. Please refer to your benefit plan information for any referral or authorization requirements.

Important Notice regarding Urgent Care services: Some urgent care centers are hospital-owned which may affect your benefits and cause a possible higher out-of-pocket cost share. For details on your coverage with each type of facility, check your Benefit Plan Document or Evidence of Coverage (EOC).

If searching for an organ or stem cell transplant provider, please call our toll-free number for support: 1-866-421-5663. If you use a TTY, call 711. Our hours are Monday – Friday, 8 a.m. – 8 p.m., Eastern time.

Clinical quality and Cost- efficiency results are displayed for a subset of physicians. If “Not enough information to measure” displays, it means that the provider does not have enough data for performance evaluation. For a full listing of provider types and specialties evaluated, please visit Care Highlight

The primary focus of these ratings is transparency and should only be used as a guide when choosing care. Patients are encouraged to consider all relevant information and to consult with their treating physician.

If you are unable to locate a gender-affirming treatment provider, we will identify a gender-affirming treatment provider for you.

Some providers may choose not to perform certain services based on religious or moral beliefs.

Colorado: If you wish to file a complaint with Humana or with the Colorado Division of Insurance related to the accuracy of the provider directory and/or the provider experience, you may do so as follows:

  • With Humana: Contact Humana at the phone number on the back of your ID card.
  • With the Colorado Division of Insurance: complaints can be filed online by accessing this File a Complaint link , opens new window. The division can also be contacted by calling: 303-894-7499, or toll free outside the Denver Metro Area: 800-930-3745.

Sources of provider information and reporting updated provider information

The information in the provider listings is provided to Humana primarily by providers and/or their group practices and affiliated organizations. In limited instances, portions of the information are supplemented by other third parties such as provider data partners and government entities. Humana continually strives to provide the most accurate and up to date information possible, but changes can occur with a provider’s information without Humana receiving timely notification. Current Humana members can report inaccurate provider directory information by calling Humana Customer Service at the toll-free number on the back of your ID card or by visiting Humana.com/help.

Telehealth

Limitations on telehealth services, also referred to as virtual visits or telemedicine, vary by state. These services are not a substitute for emergency care and are not intended to replace your primary care provider or other providers in your network. Any descriptions of when to use telehealth services are for informational purposes only and should not be construed as medical advice. Please refer to your evidence of coverage for additional details on what your plan may cover or other rules that may apply.

California: Covered services provided via telehealth are also available on an in-person basis at an in-network or out-of-network provider of your choice, although selection of an out-of-network provider may result in a higher cost-sharing obligation for you. In-network providers will not balance bill you for covered services you receive. Acceptance of covered services from a third-party telehealth provider and submission of claims will serve as consent to the terms of service provided in this notice.

Participating dentists listed here are not the agents, employees or partners of HumanaDental, or any of their affiliates or subsidiaries. They are independent contractors. HumanaDental is not a provider of dental services. HumanaDental does not endorse or control the clinical judgment or treatment recommendations made by the dentists listed here or otherwise selected by you. Dentists affiliated with an office may not provide services at all locations shown on this directory. Please check with your Dentist to confirm where he or she provides services. The dentist provides and updates this information.

Some plans may require you to obtain a referral from your Primary Care Dentist, or prior authorization from the plan, before receiving certain services. Please refer to your benefit plan information or Evidence of Coverage (EOC) for any referral or authorization requirements.

If a dental provider is not shown as being handicap accessible, he/she is handicap inaccessible.

Texas: The plans provide benefits for contracted and non-contracted dentists. Non-contracted dentists have not agreed to provide services at contracted fees. If a member sees a non-contracted dentist, their out-of-pocket costs may be higher than that charged by contracted dentists. You may sometime see this referenced with the terms of in and out of network.

Other pharmacies may be available in our network. You can locate network pharmacies by visiting Humana.com/finder/pharmacy.

CenterWell Pharmacy is the preferred cost-sharing mail-order pharmacy under many Humana MAPD and PDP plans. There are other pharmacies, including preferred cost-sharing retail pharmacies, are available in our network. Members can choose any network pharmacy for their prescriptions.

The Humana Prescription Drug Plan (PDP) pharmacy network includes limited lower-cost, preferred pharmacies in urban areas of CT, DE, IA, MA, ME, MN, MO, MS, ND, NJ, NY, RI, SD; suburban areas of CT, DE, MA, ME, MN, MT, ND, NJ, NY, PA, PR, RI; and rural areas of IA, MN, MT, ND, NE, SD, VT, WY. There are an extremely limited number of preferred cost share pharmacies in urban areas in the following states: DE, ME, MN, MS, ND; suburban areas of: MT and ND; and rural areas of: ND. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call Customer Care at 800-281-6918 (TTY: 711) or consult the online pharmacy directory at Humana.com.

To take full advantage of the savings available with your benefits, choose a doctor within your network for routine care. With the exception of emergencies and urgent care situations, it may cost more for covered services received outside the network.

Out-of-network/non-contracted providers are under no obligation to treat Humana plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

CenterWell does not administer Pharmacy Benefits for KY Medicaid members. KY Medicaid members should go to the following link to learn about their pharmacy benefits.

MedImpact Medicaid Provider Portal for Managed Care, opens new window

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