The Humana Care Management team provides support for patients with chronic and complex medical conditions. Our patient-centric, Individualized Care Plan (ICP) is developed with an Interdisciplinary Care Team (ICT), which includes the Humana Care Manager and the primary care physician.

Who is eligible?

  • Services are available for select and qualifying Medicare and Medicaid members, including:
    • High-risk members in Medicare Advantage plans
    • Illinois Medicaid & Medicare members under the Humana Gold Plus® Integrated Medicare-Medicaid health plan
    • Members in D-SNP and C-SNP plans are automatically enrolled. SNP members that engage with Humana Care management have 12% higher HEDIS scores. A physician referral increases the likelihood members will engage with Humana Care Management.

What is the cost?

  • Our programs are available to eligible patients at no additional cost.

Health programs

  • Cancer program
  • HumanaBeginnings
  • Case and care management
  • Neonatal intensive care
  • Renal disease programs
  • Meal Delivery Benefit
  • Humana Community Navigator

How to make a referral

Review eligibility

Patients who may be eligible for Humana Care Management include those who:

  • Have a comorbid/medically complex chronic condition OR a poorly controlled health condition that significantly limits overall health/function AND:
    • Requires intensive care coordination OR additional support  OR
    • Requires extensive resources and/or services to regain optimal health
  • Are at high risk for hospitalization due to a medical condition that requires longer‐term support 
  • Require frequent adjustments in their treatment plan
  • Lack resources or the ability to self‐manage (i.e., food insecurity, unstable housing, lack of transportation or inability to afford medications)

Submit the referral form

Follow these steps to submit a referral: 
  1. Complete the  referral form  
  2. Submit form via:
    • Fax: 877-770-0651
    • Email:  HAH_Providerreferrals@humana.com
  3. Receive confirmation
    • You will receive acknowledgement of receipt of your referral via the email provided.
    • If your patient meets the criteria for Humana Care Management, 1 of our referral specialists will contact your patient to enroll in our services. Once the patient agrees to participate, a care manager will reach out to your patient directly and help oversee their healthcare needs.
    • If you’re a value-based care provider, you can access care management member information on your Population Insights Compass dashboard. 

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