Other Humana Sites Help Español Shop for Plans Member Resources Sign in Home Member guidance Humana Member Rights Humana member rights Get the care you deserve. Find information about authorizations, low-income subsidy and more. Continue to MyHumana Your rights and responsibilities The rights and responsibilities statement reminds members and healthcare providers of their roles in maintaining a productive relationship. Rights and responsibilities Medical Authorizations Find out if your doctor or hospital needs advanced approval to cover costs for certain medical procedures, services, or medications. Medical authorizations Pharmacy authorizations Before filling a prescription for some medications, you may have to get approval from Humana to make sure the medication is covered under your plan. Pharmacy authorizations Disenrollment and cancellation Discover when and how to cancel or disenroll from your Humana Medicare Advantage or prescription drug plan. Disenrollment and cancellation Exceptions and appeals Find answers to your questions and concerns about filing an exception, appeal or grievance and appointing a representative. Exceptions and appeals Medical organization determination You have the right to ask Humana to pay for items or services you think should be covered. If you are a Medicare member, this is called a request for an organization determination. Medical organization determination Low income subsidy You may be eligible for “Extra Help” or a low-income subsidy with payments for your prescription drug plan, deductible and copayments. Access forms online. Low income subsidy Quality Improvement (QI) program Humana wants to provide you with quality care so we have developed a program to make sure we are always improving. Find more information in the Quality Improvement program description overview , PDF opens new window or call 1-800-4-HUMANA (1-800-448-6262) for a printed copy. New medical technology Humana follows strict guidelines to make sure the care you are getting is clinically sound and of your best interest. New medical technology Utilization Management Utilization management is used to determine whether a service or treatment is medically necessary and appropriate for payment under your benefit plan. Humana does not reward or provide financial incentives to doctors, other individuals or Humana employees for denying coverage or encouraging under use of service. If you have questions or concerns related to UM, staff are available at least eight hours a day during normal business hours. If you have questions or disagree with a coverage decision, call Member Service at the number on your ID card. More resources FAQs Learn more about plans through answers to frequently asked questions. FAQs Help and support Find tools, answers to frequently asked questions and contact information. Help and support Ask Humana Humana members can ask us anything. Find answers through our smart search tool. Ask Humana Back to top Medicare Dental Vision Medicaid Pharmacy Member Resources Find a Doctor Sign in to MyHumana Sign in to Go365.com Employers Agents & Brokers Providers Caregivers About Humana Contact Us Careers Investor Relations Corporate Responsibility © Humana 2021 Legal Privacy Policies Internet Privacy Statement Site Map Disclaimers & Licensure Fraud, Waste & Abuse Accessibility System Requirements This material is provided for informational use only and should not be construed as medical advice or used in place of consulting a licensed medical professional. You should consult your doctor to determine what is right for you. 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. Y0040_GHHHG57HH_v3 Approved Last Updated: 10/01/2015