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Log in to Availity Essentials™ to access patient benefits, claims information and more.

Find tools and materials to support doing business with us.

Learn more about research and trends that impact your practice.

Find self-service info and phone numbers and update your provider data.

Review prior authorization lists for services, medications and submission guidance.

Prior authorization submission information

Professionally administered drugs prior authorization

Find appeals guidelines and payment policy information.

Learn how to submit claims and find coding guidance.

Find policies for procedures, devices and medications.

Review guidelines and health programs to support your patients and practice.

Find dental benefits, tools and resources.

Prior authorization for professionally administered drugs 

Locate state-specific resources for Humana Healthy Horizons® (Medicaid).

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Humana Healthy Horizons in Kentucky

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Humana Healthy Horizons® in Kentucky is more than a health plan. We are committed to providing what you need to give our enrollees the best care possible. Humana Healthy Horizons features great medical benefits and more, including our Go365 for Humana Healthy Horizons® rewards program, expanded vision services, childcare assistance, and helpful digital tools to help enrollees better manage their health.

Humana contracts with the Kentucky Cabinet for Health and Family Services to provide services to Medicaid enrollees through Humana Healthy Horizons. Medicaid provides healthcare coverage for income-eligible children, seniors, disabled adults, pregnant women, and other eligible adults. It is funded by both the state and federal governments.

Humana uses nationally recognized medical necessity guidelines (e.g., Milliman Care Guidelines [MCG] and American Society of Addiction Medicine® criteria). Criteria are readily available for review by Kentucky Department for Medicaid Services (Kentucky DMS), practitioners, the public, or enrollees on request and at no cost. MCG guidelines are available either verbally or in writing on request. For providers and practitioners, the process to obtain criteria is communicated annually in the provider newsletter and provider manual.

Access Humana medical coverage policies

Kentucky DMS has issued updated prior authorization guidance.

Review prior authorization guidance

Qualifying enrollees with type 2 diabetes can work with a health coach through Vida Health. Visit Vida Health or call 855-910-1215 (TTY: 711) to learn more. To refer a patient you believe could benefit from this program, call 855-910-1215 (TTY: 711).

About Humana Healthy Horizons in Kentucky

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Kentucky Medicaid