If you want your caregiver to have access to your health information, you need to fill out the protected health consent form. Download and complete the forms and return the completed forms to us.

Consent for release of Protected Health Information – English

Consent for release of Protected Health Information – Spanish

Behavioral health consent for release of PHI

Carelon Behavioral health consent for release of PHI

We want you to be happy with the care you get from Humana Healthy Horizons in Florida. We hope you get the best care possible

If you are not happy with any part of your healthcare plan, Customer Care, your doctor, or a facility, you can send in a grievance. You also can appeal a claim or a denied service using this form

If you are sending an appeal or grievance for another covered member, be sure to fill out an Appointment of Representative form

Grievance/Appeal request form – English

Grievance/Appeal request form – Spanish

Appointment of representative form – English / Spanish

Your healthcare is our priority. We know your private duty nursing (PDN) services are important. Your relationship with the agency providing the services is important, too.

To make sure you get the high-quality care you need and deserve, we put in place a new way to report your issues and concerns in real time. Issues and concerns may include problems like:

• Nurses missing shifts
• Nurse no-shows
• No nurse available

Learn more about our real-time reporting requirements and process

• You can complete your HRA by:
• Filling out the HRA and sending it back to us in the postage-paid envelope you received in your Welcome Kit, OR
• Calling us at 800-611-1467 (TTY: 711), OR
• Completing it in your MyHumana account online or in the app.

Health Risk Assessment (HRA) – English

Health Risk Assessment (HRA) – Spanish

Health Risk Assessment (HRA) – Creole

These notices provide information about how Humana uses, and when we might share, your personal information. They also outline the various privacy rights available to you.

Individual privacy rights – English and Spanish

Rights and responsibilities – English

Rights and responsibilities – Spanish

HIPAA privacy notice – English

HIPAA privacy notice – Spanish

A living will is an important document every adult should complete. A living will lets you clarify in writing what you want family or other healthcare proxy to do if you’re not in a position to make healthcare decisions for yourself

Living will – English and Spanish

LTC Consent to share health facts – English

LTC Consent to share health facts – Spanish

LTC Consent for release of information – English

LTC request for alternative communications – English

Do you have any questions about your plan? Check out the Member Handbook to find full details of your plan and benefits. You can find information about the Humana Medical Plan, Humana Long-Term Care Plan, and Humana Comprehensive Plan.

Member Handbook

Over-the-counter order forms

Your pharmacy benefit lets you order certain over-the-counter (OTC) items through the mail. Use this catalog to look up OTC items you want to order each month. Fill out the form and mail, fax or phone your order to CenterWell Pharmacy

Over-the-counter order form – English

Over-the-counter order form – Spanish

Preferred Drug List

Understanding your medicine coverage is important. Check the lists below to see the medicines your plan covers.

View the AHCA Preferred Drug List.

Cystic Fibrosis Supplemental Drug Lists – English

Cystic Fibrosis Supplemental Drug Lists – Spanish

Recent Changes to Florida Medicaid Drug List – English

Recent Changes to Florida Medicaid Drug List – Spanish

Prescription drug reimbursement claim form

We hope you don’t have to pay for any medicine out of pocket. If it happens, let us know by filling out a reimbursement claim form, and we will try to pay you back. Fill out this form to send in a reimbursement claim if you paid out of pocket for a prescription.

Prescription drug reimbursement claim form

Region A

Bay, Calhoun, Escambia, Franklin, Gadsen, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton, and Washington

Provider Directory – English and Spanish – (FL counties: Bay, Escambia, Holmes, Okaloosa, Santa Rosa, Walton, and Washington. AL counties: Baldwin, Covington, Escambia, Geneva, Houston, and Mobile. GA counties: Cook, Dekalb, Glynn, and Lowndes)

Provider Directory – English and Spanish – (Calhoun, Dixie, Franklin,  Gulf, Hamilton, Holmes,  Jefferson, Lafayette,  Liberty, Madison, Suwanee, Taylor, and Washington counties) 

Provider Directory – English and Spanish – (Bay, Gadsden, Jackson, Leon, Wakulla, and Walton counties)

Long-Term Care Provider Directory – English and Spanish – (Bay, Escambia, Holmes, Okaloosa, Santa Rosa, Walton, and Washington counties)

Long-Term Care Provider Directory – English and Spanish – (Bay, Calhoun, Dixie, Franklin, Gadsden, Gulf, Hamilton, Holmes, Jackson, Jefferson, Lafayette, Leon, Liberty, Madison, Suwanee, Taylor, Wakulla, Walton, and Washington counties)

Region B

Alachua, Baker, Bradford, Citrus, Clay, Columbia, Dixie, Duval, Flagler, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Nassau, Putnam, St. Johns, Sumter, Suwanee, Union, and Volusia

Provider Directory – English and Spanish – (Alachua county)

Provider Directory – English and Spanish – (Volusia county)

Provider Directory – English and Spanish – (Bradford, Columbia, and Dixie counties)

Provider Directory – English and Spanish – (Baker, Flagler, and Putnam counties)

Provider Directory – English and Spanish – (Citrus and Lake counties)

Provider Directory – English and Spanish – (Clay and Marion counties)

Provider Directory – English and Spanish – (Pasco county)

Provider Directory – English and Spanish – (Polk and Taylor counties)

Provider Directory – English and Spanish – (Seminole and St. Johns counties)

Provider Directory – English and Spanish – (Gilchrist, Hamilton, Hernando, and Lafayette counties)

Provider Directory – English and Spanish – All Provider Types except Behavioral Health – (Hillsborough county)

Provider Directory – English and Spanish – Behavioral Health – (Hillsborough county)

Provider Directory – English and Spanish – (Levy, Sumter, Suwannee, and Union counties)

Provider Directory – English and Spanish – (Madison and Osceola counties)

Provider Directory – English and Spanish – (Orange county)

Provider Directory – English and Spanish – (Baker,  Flagler, and Nassau counties)

Provider Directory – English and Spanish – (Clay and Volusia counties)

Provider Directory – English and Spanish – (Alachua and Lake counties)

Provider Directory – English and Spanish – (Bradford, Brevard, and Union counties)

Provider Directory – English and Spanish – (Columbia and Marion counties)

Provider Directory – English and Spanish – All Provider Types  except Behavioral Health - Part 1 of 2 – (Orange county)

Provider Directory – English and Spanish – All Provider Types  except Behavioral Health - Part 2 of 2 – (Orange county)

Provider Directory – English and Spanish – Behavioral Health Part 2 of 2 – (Orange county)

Provider Directory – English and Spanish – Behavioral Health – (Orange county)

Provider Directory – English and Spanish – (Putnam and Seminole counties)

Provider Directory – English and Spanish  – All Provider Types except Behavioral Health – (Duval and St. Johns)

Provider Directory – English and Spanish – Behavioral Health – (Duval and St. Johns counties)

Long-Term Care Provider Directory - English and Spanish – (Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwanee, and Union counties)

Long-Term Care Provider Directory - English and Spanish – (Baker, Clay, Flagler, Hillsborough, Madison, and Orange counties)

Long-Term Care Provider Directory - English and Spanish – (Osceola, Pasco, Polk, Seminole, St. Johns, Taylor, and Volusia counties)

Long-Term Care Provider Directory - English and Spanish – (Baker, Clay, Duval, Flagler, Nassau, St. Johns, and Volusia counties)

Long-Term Care Provider Directory - English and Spanish – (Alachua, Bradford, Brevard, Columbia, Lake, Marion, Orange, Putnam, Seminole, and Union counties)

Region C

Pasco and Pinellas

Provider Directory – English and Spanish – (Lake and Pasco counties)

Provider Directory – English and Spanish – (Polk and Sumter counties)

Provider Directory – English and Spanish – (Citrus and Hernando counties)

Provider Directory – English and Spanish – All Provider Types except Behavioral Health – (Hillsborough county)

Provider Directory – English and Spanish – Behavioral Health – (Hillsborough county)

Provider Directory – English and Spanish – (Pinellas county)

Long-Term Care Provider Directory – English and Spanish – (Citrus, Hernando, Hillsborough, Lake, Pasco, Pinellas, Polk, and Sumter counties)

Region D

Hardee, Highlands, Hillsborough, Manatee, and Polk

Provider Directory – English and Spanish – All Provider Types except Behavioral Health – (Hillsborough county)

Provider Directory – English and Spanish – Behavioral Health – (Hillsborough county)

Provider Directory – English and Spanish – (Manatee county)

Provider Directory – English and Spanish – (Desoto, Glades, Hernando, and Okeechobee counties)

Provider Directory – English and Spanish – (Hardee, Highlands, and Osceola counties)

Provider Directory – English and Spanish – (Lake and Sumter counties)

Provider Directory – English and Spanish – (Charlotte and Pasco counties)

Provider Directory – English and Spanish – All Provider Types except Behavioral Health – (Orange county)

Provider Directory – English and Spanish – Behavioral Health – (Orange county)

Provider Directory – English and Spanish – (Pinellas County)

Provider Directory – English and Spanish – (Polk and Sarasota counties)

Long-Term Care Provider Directory – English and Spanish – (Hardee, Highlands, Hillsborough, Manatee, and Polk counties)

Long-Term Care Provider Directory – English and Spanish – (DeSoto, Glades, Hernando,Sarasota, and Sumter counties)

Long-Term Care Provider Directory – English and Spanish – (Charlotte, Lake, Okeechobee, Orange, Osceola, Pasco, and Pinellas counties) 

Region E

Brevard, Orange, Osceola, and Seminole

Provider Directory – English and Spanish – (Highlands, Indian River, and Lake counties)

Provider Directory – English and Spanish – (St. Lucie, and Volusia counties)

Provider Directory – English and Spanish – (Okeechobee, and Osceola counties)

Provider Directory – English and Spanish – All Provider Types except Behavioral Health – (Orange county)

Provider Directory – English and Spanish – Behavioral Health – (Orange county)

Provider Directory – English and Spanish – (Polk County)

Long-Term Care Provider Directory – English and Spanish – (Highlands, Indian River, Osceola, St. Lucie and Seminole counties)

Long-Term Care Provider Directory – English and Spanish – (Brevard, Lake, Okeechobee, Orange, Polk, and Volusia counties)

Region F

Charlotte, Collier, Desoto, Glades, Hendry, Lee, and Sarasota

Provider Directory – English and Spanish – (Charlotte, DeSoto, Glades, Hardee, and Highlands counties)

Provider Directory – English and Spanish – (Hendry and Lee counties)

Provider Directory – English and Spanish – (Collier and Sarasota counties)

Provider Directory – English and Spanish – All Provider Types except Behavioral Health – (Hillsborough county)

Provider Directory – English and Spanish – Behavioral Health – (Hillsborough county)

Provider Directory – English and Spanish – (Manatee county)

Provider Directory – English and Spanish – (Monroe county)

Provider Directory – English and Spanish – All Provider Types except Behavioral Health – (Okeechobee and Palm Beach counties)

Provider Directory – English and Spanish – Behavioral Health – (Okeechobee and Palm Beach counties)

Long-Term Care Provider Directory – English and Spanish – (Charlotte, Collier, DeSoto, Glades, Hendry, Lee, and Sarasota counties)

Long-Term Care Provider Directory – English and Spanish – (Broward, Hardee, Highlands, Hillsborough, and Manatee counties)

Long-Term Care Provider Directory – English and Spanish – (Okeechobee and Palm Beach counties)

Long-Term Care Provider Directory – English and Spanish – (Miami-Dade and Monroe counties)

Region G

Indian River, Martin, Okeechobee, Palm Beach, and St. Lucie

Provider Directory – English and Spanish – (Brevard, Glades, Indian River, Martin, Okeechobee, and St. Lucie counties)

Provider Directory – English and Spanish – (Palm Beach county)

Provider Directory – English and Spanish – (Hendry and Polk counties)

Provider Directory – English and Spanish – (Highlands and Osceola counties)

Long-Term Care Provider Directory – English and Spanish – (Indian River, Martin, Okeechobee, Palm Beach, and St. Lucie counties)

Long-Term Care Provider Directory – English and Spanish – (Brevard, Broward, Glades, Hendry, Highlands, Osceola, and Polk counties)

Region H

Broward

Provider Directory – English and Spanish – (Broward county) – Behavioral Health Services, Durable Medical Equipment, Hospitals, Laboratory Services, Pharmacies, Primary Care Providers, Urgent Care Centers, and Vision Providers

Provider Directory – English and Spanish – (Broward county) – Other Healthcare Providers and Specialists

Provider Directory – English and Spanish – (Collier county)

Provider Directory – English and Spanish – (Hendry county)

Provider Directory – English and Spanish – (Palm Beach County)

Long-Term Care Provider Directory – English and Spanish – (Broward, Collier, and Palm Beach counties)

Long-Term Care Provider Directory – English and Spanish – (Hendry and Miami-Dade counties)

Region I

Miami-Dade and Monroe

Provider Directory – English and Spanish – All Provider Types except Behavioral Health – (Collier and Palm Beach Counties)

Provider Directory – English and Spanish – Behavioral Health – (Collier and Palm Beach Counties)

Provider Directory – English and Spanish – All Provider Types except Behavioral Health and Specialists – (Miami-Dade county)

Provider Directory – English and Spanish – Behavioral Health – (Miami-Dade County)

Provider Directory – English and Spanish – (Monroe county)

Provider Directory – Specialists – English and Spanish – (Miami-Dade county)

Long-Term Care Provider Directory – English and Spanish – (Miami-Dade county)

Long-Term Care Provider Directory – English and Spanish – (Collier and Monroe counties)

Long-Term Care Provider Directory – English and Spanish – (Broward and Palm Beach counties)

We hope you don’t have to pay out of pocket for the benefits you get as a Humana Healthy Horizons in Florida member. If you do, let us know by filling out a reimbursement claim form, and you may get a refund. Fill out one of the forms below to send a reimbursement claim.

Expanded benefits reimbursement form – English

Expanded benefits reimbursement form – Spanish

Medicaid overnight reimbursement form – English

Medicaid overnight reimbursement form – Spanish