9 Humana Florida Medicaid Facts nobody explains: Get the honest truth
Choosing the right Florida Medicaid health plan is an important decision for individuals and families who depend on affordable healthcare. Understanding available benefits, participating doctors, prescription coverage, transportation, and additional healthcare services can help Medicaid recipients make informed decisions.
One option available to eligible Florida residents is Humana Healthy Horizons in Florida. Through its partnership with the Florida Agency for Health Care Administration (AHCA), Humana provides Medicaid coverage through its Managed Medical Assistance (MMA) program and Long-Term Care (LTC) services.
Whether you are considering Humana Florida Medicaid or already enrolled, understanding your healthcare benefits and available resources can help you get the most out of your coverage.
What Is Humana Healthy Horizons in Florida?
Humana Healthy Horizons is a managed care organization contracted with Florida Medicaid to provide healthcare coverage and coordinated medical services to eligible residents. Its programs are designed to help children, pregnant women, adults, seniors, and individuals with disabilities access necessary medical care. Humana offers several Florida Medicaid coverage options, including:
Managed Medical Assistance (MMA)
Long-Term Care (LTC)
Specialty coverage for individuals with serious mental illness (SMI)
Specialty coverage for individuals with HIV/AIDS
These programs provide access to different types of medical services depending on eligibility and healthcare needs. For additional information, visit the official Humana Florida Medicaid website.
Humana Florida Medicaid Managed Medical Assistance (MMA)
The Managed Medical Assistance program is part of Florida's Statewide Medicaid Managed Care (SMMC) system. Through its MMA program, Humana provides eligible Medicaid recipients with access to a network of participating healthcare providers and covered medical services. Benefits include:
1. Primary Care and Doctor Visits
Primary care is an essential part of maintaining good health. Humana members can access participating primary care providers for routine medical appointments, preventive screenings, and treatment of common illnesses.
Humana also offers additional primary care benefits, including unlimited primary care visits for eligible non-pregnant adult members age 21 and older. Having an established primary care provider can help members coordinate specialist appointments and maintain consistent medical care.
2. Prescription Drug Coverage
Humana Florida Medicaid provides prescription medication benefits through its pharmacy network. Members can obtain covered medications prescribed by participating healthcare providers. However, specific medications may be subject to formulary restrictions, prior authorization, and other coverage requirements.
Members should review their current pharmacy benefits and medication formulary before filling prescriptions.
3. Vision and Hearing Services
Vision and hearing benefits help Medicaid recipients address important healthcare needs.
Humana offers covered vision and hearing services, including additional adult visual aid benefits for eligible members.
Depending on eligibility and program requirements, additional services may include annual eye examinations, eyeglasses, contact lenses, hearing evaluations, and hearing aids.
4. Behavioral Health Services
Behavioral health services are an important component of Humana's Florida Medicaid coverage. Members can access covered behavioral healthcare services through participating providers.
Humana also offers specialty Medicaid coverage for individuals with serious mental illness and HIV/AIDS who meet applicable program requirements. These programs help coordinate healthcare services for members who may require additional medical and behavioral health support.
5. Physical and Occupational Therapy
Members who need rehabilitation or assistance improving daily functioning may qualify for covered therapy services. Humana's medical coverage includes:
Physical therapy
Occupational therapy
Respiratory therapy
Speech therapy
Chiropractic services
Podiatry services
Medical necessity, treatment limits, and authorization requirements may apply.
Additional Humana Florida Medicaid Benefits
One feature of Humana Healthy Horizons is its expanded benefits program. In addition to traditional Medicaid coverage, Humana offers additional services intended to support members' overall health and quality of life. Depending on eligibility, additional benefits may include:
Adult vision assistance
Hearing services
Over-the-counter medications and supplies
Home-delivered meals
Transportation assistance
Pregnancy and maternity support
Doula services
Digital blood pressure monitoring equipment
Financial literacy coaching
GED preparation assistance
Disaster preparedness meals
Home-based asthma interventions
Housing assistance for eligible members
Humana also offers Go365 for Humana Healthy Horizons, a wellness rewards program that encourages members to participate in healthy activities.
Some benefits have specific age, medical, enrollment, and participation requirements. Members should review the current expanded benefits information before requesting services.
Humana Pregnancy and Maternal Healthcare Benefits
Pregnant women enrolled in Humana Healthy Horizons may qualify for additional maternal healthcare services.
The Humana Beginnings care management program provides pregnancy-related support and resources to eligible members. Additional benefits may include:
Prenatal and postpartum visits
Pregnancy care coordination
Doula services
Breast pump assistance
Home-delivered meals for eligible high-risk pregnancies
Convertible car seats or portable cribs for qualifying members
Maternal and infant virtual care
These services are intended to help pregnant members access appropriate healthcare throughout pregnancy and after delivery.
Eligibility requirements and participation conditions apply to certain expanded benefits.
Humana Florida Medicaid Long-Term Care (LTC)
Florida Medicaid Long-Term Care provides services for eligible individuals who need assistance with daily living activities or ongoing healthcare support.
Humana's LTC program helps eligible adults receive coordinated medical care and long-term support services. Covered services may include:
Personal care assistance
Homemaker services
Adult day healthcare
Nursing facility services
Assisted living services
Respite care
Skilled nursing
Home-delivered meals
Physical and occupational therapy
Medical equipment and supplies
Transportation
Care coordination
One important feature of Humana's Long-Term Care program is its care coach service.
Care coaches work with members, caregivers, doctors, and other healthcare professionals to develop individualized care plans.
These plans help coordinate approved services based on the member's medical history, current needs, living situation, and available family support.
How to Qualify for Florida Medicaid Long-Term Care
Individuals interested in Long-Term Care must complete Florida's screening and eligibility process. The process generally involves three steps:
Screening: Contact your local Aging and Disability Resource Center (ADRC) to complete the initial screening.
Eligibility assessment: The appropriate state agencies evaluate medical and financial eligibility.
Enrollment: Individuals who are approved receive information about selecting an available Long-Term Care managed care plan.
Enrollment capacity for certain home and community-based services is limited. Individuals may be placed on a waiting list.
Humana Florida Medicaid Service Areas
Humana Healthy Horizons serves eligible Medicaid members across several Florida Medicaid regions. Its published service areas include:
Region | Counties |
Region A | Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Washington |
Region B | Alachua, Baker, Bradford, Citrus, Clay, Columbia, Dixie, Duval, Flagler, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Nassau, Putnam, St. Johns, Sumter, Suwannee, Union, Volusia |
Region C | Pasco, Pinellas |
Region D | Hardee, Highlands, Hillsborough, Manatee, Polk |
Region E | Brevard, Orange, Osceola, Seminole |
Region F | Charlotte, Collier, DeSoto, Glades, Hendry, Lee, Sarasota |
Region G | Indian River, Martin, Okeechobee, Palm Beach, St. Lucie |
Region H | Broward |
Region I | Miami-Dade, Monroe |
Residents should verify current plan availability in their county before selecting Humana Medicaid coverage.
How to Find a Humana Florida Medicaid Doctor
Finding a doctor who accepts your Medicaid health plan is essential for maintaining consistent healthcare.
Humana provides an online Find Care directory that allows members to search for participating healthcare providers and facilities. Members can search for:
Primary care physicians
Medical specialists
Hospitals
Pharmacies
Behavioral health providers
Other participating healthcare professionals
To find a participating provider:
Visit the official Humana Florida Medicaid website.
Select Find Care.
Search for a doctor, hospital, or pharmacy.
Verify that the provider accepts your specific Humana Medicaid plan.
Confirm appointment availability before scheduling.
Provider networks can change, so always verify participation before receiving non-emergency medical services.
How to Enroll in Humana Florida Medicaid
Florida residents must meet Medicaid eligibility requirements before enrolling in a managed care plan. Individuals can apply for Medicaid through the Florida Department of Children and Families (DCF).
Once approved, eligible recipients can select an available managed care organization through Florida's Medicaid enrollment process. To enroll in Humana Healthy Horizons:
Confirm your Florida Medicaid eligibility.
Verify that Humana is available in your county.
Compare available Medicaid managed care plans.
Review Humana's benefits and participating provider network.
Complete the health plan selection process.
For enrollment assistance, contact Florida's Medicaid Enrollment Broker.
Florida Medicaid Choice Counseling:
Telephone: 1-877-711-3662
TTY: 711
The enrollment broker can answer questions about available plans, enrollment, and changing managed care organizations.
Humana Florida Medicaid Contact Information
Members can use Humana's online resources to obtain information about benefits, provider directories, prescriptions, and healthcare services.
Humana Healthy Horizons in Florida
Official website: https://www.humana.com/medicaid/florida-medicaid
Member portal: MyHumana
Provider directory: Humana Find Care
Enrollment assistance: 1-877-711-3662
Long-Term Care customer service: 1-888-998-7732
Existing members should consult their member identification card or official member handbook for the appropriate contact number for their specific plan.
Humana Florida Medicaid FAQs
1. Is Humana a Florida Medicaid health plan?
Yes. Humana Healthy Horizons in Florida is a managed care plan contracted with Florida Medicaid to provide MMA and Long-Term Care services to eligible members.
2. Does Humana Florida Medicaid cover prescriptions?
Yes. Prescription medication coverage is included in applicable Medicaid benefits. Specific medications are subject to formulary and coverage requirements.
3. Does Humana Medicaid provide transportation?
Transportation is included among Humana's Medicaid benefits. Specific transportation services and eligibility requirements depend on the member's plan.
4. Does Humana offer Florida Medicaid Long-Term Care?
Yes. Humana provides Long-Term Care coverage for eligible adults who need assistance with daily activities and ongoing support services.
5. How can I find a Humana Medicaid doctor?
Visit Humana's website and use the Find Care directory to search for participating doctors, specialists, hospitals, and pharmacies.
6. How do I change my Florida Medicaid health plan to Humana?
Contact Florida Medicaid Choice Counseling at 1-877-711-3662 to learn about available plans, eligibility, and enrollment options.
The Wrap Up
Humana Healthy Horizons in Florida provides healthcare coverage and additional support for eligible Florida Medicaid recipients.
Its Managed Medical Assistance program includes access to primary care, prescription medications, behavioral healthcare, vision and hearing services, and additional wellness benefits.
Its Long-Term Care program provides coordinated services for eligible adults who need ongoing assistance and support with daily living activities.
Before choosing Humana, compare its benefits, provider network, pharmacy coverage, service area, and additional member services with other Florida Medicaid managed care plans.
Disclaimer:
This article is for educational and informational purposes only and does not constitute medical, legal, or financial advice. Program eligibility, benefits, and requirements may change. Always verify current information directly with the Florida Department of Health or the appropriate government agency before making healthcare or coverage decisions. Read full disclaimer.
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