Humana Member Guidelines

Version 1

    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