When you enroll with Humana Healthy Horizons in Florida, Continuity of Care (COC) guidelines are in place to make sure you are covered during the transition to your new plan.
Health plans are required to ensure COC during the transition period for Medicaid recipients enrolled in the SMMC program. You will be able to see your doctors and fill your prescriptions like normal. COC requirements ensure that your services will continue seamlessly when you change:
- From one health plan to another
- From one provider to another,
- From one service delivery system to another (i.e., fee-for-service to managed care)
Important COC information:
- Enrollees with an effective date of February 1, 2025: If your Humana plan was effective on February 1, 2025, your COC period is up to 120 days from your effective date of enrollment.
- Enrollees with an effective date after February 1, 2025: If your Humana plan was effective after February 1, 2025, your COC period is up to 90 days after your effective date of enrollment.
- Health care providers should not cancel appointments with their current patients. Humana must honor any ongoing treatment that was authorized prior to your enrollment with Humana during your COC period.
- Providers will be paid. Providers should continue providing any services that were previously authorized, regardless of whether the provider is participating in Humana’s network. Humana must pay for previously authorized services during your COC period and must pay providers at the rate previously received during your COC period.
- Providers will be paid promptly. During the COC period, Humana is required to follow all timely claims payment contractual requirements. The Agency for Health Care Administration (AHCA) monitors all complaints to ensure that any issues with delays in payment are resolved.
- Prescriptions will be honored. Humana must allow you to continue to receive your prescriptions through your current provider until your prescriptions can be transferred to a provider in our network.
Protect your coverage. Keep your information current
Don’t lose your Medicaid coverage. When your personal information changes, like your address or phone number, update it with a few simple steps.
Go to the Florida Department of Children & Families (DCF) website, or call 850-300-4323 (TTY: 800-955-8771) Monday – Friday, 7 a.m. – 6 p.m.
If visiting the Florida DCF website:
- Log in to your MyAccess account
- Click the “Report My Changes” button
- Check the box for Address, Email, or Phone Number changes
- Enter your information and follow prompts to finish and submit
Supplemental Security Income (SSI) recipients and those interested in getting SSI should visit the Social Security Administration website to make sure their info is up to date. Or, call the Social Security Administration at 800-772-1213 (TTY: 800-325-0778), Monday – Friday, [8 a.m. – 7 p.m.
By taking these steps, your health benefits and plan stay protected.
Have questions?
Your Member Handbook is the best resource to find everything you want to know about your plan in one place.
Call Member Services at 800-477-6931 (TTY:711), Monday – Friday, 8 a.m. – 8 p.m., Eastern Time