Humana Information

Humana

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Humana’s Member Assistance Program

The Humana Member Assistance Program (MAP) is a mandatory supplemental benefit available in all Humana Medicare Advantage plans. MAP supports members by providing counseling and elder care or childcare resource referrals for services in their community — at no additional cost. Services now include unlimited call support for Caregivers. MAP services include counseling and support for issues like:

  • Grief and loss
  • Taking care of others
  • Transitioning to retirement
  • Loneliness

To learn more about this valuable benefit available on all Humana Medicare Advantage plans, see the Member Assistance Program Flyer and Member Assistance Program FAQs.

The Humana Pharmacy – Medications by Mail or by App:

Reasons to consider mail delivery pharmacies:

  • Convenience – Members may be eligible to get a 3-month supply of maintenance medication with each order, so they only need to refill 4 times a year.
  • Guidance – Members can speak directly with a pharmacist or pharmacy technician.
  • Service & accuracy – Humana Pharmacy pharmacists independently review each new prescription for accuracy and possible drug
  • Service & accuracy – Humana Pharmacy pharmacists independently review each new prescription for accuracy and possible drug interactions. Humana Pharmacy foil-sealed containers add safety and security.

Humana Pharmacy App

  • Scan to Refill – Scan prescription bottle to refill script easily.
  • Order Status – View order status, approve payment and track shipment.
  • Medicine Cabinet – Easily view all prescriptions in one place.
  • Messages – Get account updates when refills become available, orders have shipped, orders are delayed or if a balance is due.
  • Shipping and Billing – Update shipping and billing information.

How to download the Humana Pharmacy App:

Company Information

Important Phone Numbers:

Billing & Enrollment: 800-992-2551 (for billing, premium, and new enrollment issues)
Customer Service: 800-457-4708 (for all types of member inquiries)
Application Fax: 877-889-9936

Agent Support:

When contacting Humana’s Agent Support, please be sure to provide the MGA name and account number, your first and last name, your contact information, and the reason you’re calling.

Phone: 800-309-3163

  • Option 1: Certification/Recertification Questions
  • Option 3: Enrollment Questions
  • Option 4: Check Status of Enrollment
  • Option 6: Order Sales
  • Option 7: Commissions

Email: agentsupport@humana.com

Hours: Monday-Friday from 8 a.m. to 9 p.m. (EST)

To Check the Status of a Client:

In order to check the status of a client, email agentRSOS@humana.com. An email can contain either Medicare or Individual based concerns about a member’s policy. policy. Do not send Medicare and individual concerns in the same email. We recommend you use the following template for these emails.

Standard subject heading: [Member Last Name], [Member First Name] [Medicare OR Humana Individual]

Your body text must include the information below:

  • Agent Name (required)
  • Agent SAN (required)
  • Member ID # (required)
  • Member Name in question (required)
  • Reference # (if applicable)
  • Summary of issue (required)

Certification Details

Instructions for the Following Products:
  • Medicare Advantage
  • PDP
Certifications are Live:

– All Certification Courses Launch Tuesday, July 10, 2018 at Noon EST.
– All Recertification Courses Launch Tuesday, July 17, 2018 at Noon EST.
– External Agents will have until November 30, 2018 to Complete Recertification.

To access Humana’s 2018 certification training, agents must log in to the Humana agent portal using either Internet
Explorer, Edge, Firefox, or Safari (not Google Chrome) as their browser. Once logged in, they must enter the “Education” portal to access their initial certification or recertification work.

Is AHIP Required for Certification?

Yes.  AHIP can be purchased through the Care Value link for $125.00, a $50.00 discount off the original price.

Agents may also use their AHIP certification for compliance credit.

Does Aetna Reimburse for AHIP?

Humana grants AHIP reimbursement when all of the following criteria is met:

  • Agents completed the courses through the Humana agent portal
  • Agent successfully enrolled 10 MA or 40 PDP January 1, 2018, effective members
  • Members must be accreted with CMS by March 3, 2018.
How Do I Transfer My AHIP Score to Humana?

If you need to transfer your AHIP score to Humana, view Humana’s Transferring AHIP Scores job aid for more information.

Is Face-to-Face Training Required?

Agents may select face-to-face training or online training. There will also be supplemental local product roadshows leading up to AEP.

Certification Product and Compliance Training Information:

Product Modules:

  • Information currently unavailable.

Compliance Modules:

  • Information currently unavailable.
Will Certifying for 2018 Allow Me to Sell 2017 Products?

Yes, completing your 2018 certifications will allow you to continue selling 2017 products.

How Do I Retrieve My Username and Password?

Agents may contact Humana’s Agent Support Unit at 800-309-3163 or email agentsupport@humana.com for assistance.

Who Do I Contact to Confirm Certification?

Agents may contact Humana’s Agent Support Unit at 800-309-3163 or email agentsupport@humana.com to check/confirm their certification status.

Resources for Additional Information:

How to Complete Certification: http://goo.gl/9QCBuf

How to Complete Recertification: http://goo.gl/760jBS

How to Access Recertification in Vantage: http://goo.gl/188Ruc

How to Complete PDP Certification: http://goo.gl/DUudM9

Submitting Business

Announcements:

The new version of iMAPA for iPads is NOW AVAILABLE for download in Apple’s App Store. Make sure you update your software to iOS 9, so that you can access this excellent application!

Important Information:
  • All enrollment applications should be submitted within 24 HOURS of obtaining the beneficiary signature. Agents can fax the app or use the special Humana UPS overnight account. ALL enrollment applications must be received within three days of the signature date to meet CMS processing guidelines.
    • Agents not adhering to this requirement will be notified 95% of the time .
    • Agents not consistently meeting this regulation will be subject to corrective action.
  • All face-to-face meetings with Medicare beneficiaries require a Scope of Appointment (SOA) IN ADVANCE of the meeting.
    • Humana will accept either a paper SOA form or an agent can use the Interactive Voice Response (IVR) system.
    • In cases where a Medicare beneficiary is seeking a “next day” appointment, please use the IVR system to obtain the SOA in advance.
  • Do not destroy, replace, or rewrite (etc.) any application unless someone in the Humana Enrollment Department specifically tells you to do so. If given these type of instructions, document when and who gave you the instructions.
  • Applications should first be sent directly to Humana (not MGA).
Reminders for Applications:
  • A full enrollment application should be used. When in doubt, use the FULL Enrollment Application.
  • Abbreviated enrollment forms can only be used when the beneficiary is already a Humana member and the contract number is NOT changing.
  • Use black ink – print clearly and legibly on paper applications
  • Double check that the agent SAN number is written clearly on page 7 of the paper application.
  • Use the correct Group ID and Benefit Numbers on page 7 of the paper application job aid.
  • Use the correct Plan Option on page 1 of the paper application. This is shown on the Summary of Benefits.
  • Double check for the most common errors that cause applications to be “pending”
    • Invalid birth date
    • Sex type not selected
    • P.O. Box listed as the address or address incorrect for service area
    • Member signature missing
    • Invalid Medicare ID
  • Do not rewrite paper applications that are signed by a beneficiary and “received” by an agent/Humana in the MAPA/FastApp.
How to Submit Aetna MA/MAPD/PDP Enrollment Applications:

Paper Applications

  • Fax: 877-889-9936 (preferred method)
    • Please include completed application and SOA
    • SOA must be agreed to and documented either by IVR (866-945-4471) or on paper prior to the appointment taking place, unless it is not feasible.
    • The form must be a CMS-approved form. DO NOT modify (shrink or enlarge) the Humana form in any way.
    • Delegate HFPP Enrollment Fax: 800-589-9309
  • Overnight Mail:
    • Humana Medicare Enrollment
      2432 Fortune Dr.
      Lexington, KY 40509
    • Humana has established an easy-to-use UPS Overnight Account Process that you can begin using today. Effective December 1, all labels must be created from https://cvshipping.ups.com.
      • Use the UPS letter size package to ship enrollments to Humana (ACS).
      • If you have several enrollment applications ready, please ship more than one enrollment application in each overnight shipment.

Online Enrollments

  • MAPA – Medicare Advantage Paperless Application for laptop computers
    • Usable with a digital signature pad or electronic signature process (an auto-generated email to the client)
    • Does not require live internet connectivity—applications can be sent to Humana later in the day from home or the office
  • iMAPA – Medicare Advantage Paperless Application for iPads
    • Usable with a digital signature pad or electronic signature process (an auto-generated email to the client)
    • Does not require live internet connectivity—applications can be sent to Humana later in the day from home or the office
  • FastAPP – Electronic method through the Agent Portal
    • Requires internet connectivity
    • The member must have an email address so that enrollment can be verified. Please be aware that the email address provided during the FastAPP method CANNOT be the agent’s email address. It must be the enrollee’s email address in order to be a compliant enrollment. For more information, please click here.

Commissions

Agent Certification Needed to Maintain Commissions

The Centers for Medicare and Medicaid Services (CMS) requires that agents certify on a yearly basis in order to represent and enroll beneficiaries in Medicare Advantage (MA) and Prescription Drug Plans (PDP). In addition, CMS has recently revised regulation linking annual certification testing to an agent’s ability to receive renewal commissions.

Humana is extending a special invitation to any agent who has enrolled Medicare members with Humana and has let their certification lapse to recertify so that they may retain their renewal commissions. This special recertification is open for agents. Agents must have a passing score of 85 percent.

General Information:

Commissions are paid twice each month (on the 15th and the last day of the month). They are based on the enrollments entered into the system that have passed compliance credits for licensing, appointment, and certification. They do not include enrollments that have a PENDING status. Chargebacks will occur for any enrollment that is NOT confirmed by CMS as an eligible member.

Initial enrollments (first-time eligibles for Medicare and any beneficiary moving from original Medicare)

  • First installment will be disbursed at enrollment submission.
  • Second installment will be disbursed upon CMS Validation.
  • Commissions for members who disenroll within their first three effective months will result in a full chargeback of commissions.
  • Commission for members who disenroll after the first three effective months will be charged back on a prorated basis.
  • All agents must be certified to receive commission payments.

Supplies

How to Order Supplies for Humana:

Agents can order supplies through the Marketing Resource Center in Humana’s agent portal. For help navigating the site, download the Quick Start User Guide for Humana’s Marketing Resource Center.

To order Humana Medicare materials, please follow the instructions below.

  1. Go to Humana’s agent order site for Medicare materials.
  2. Log in. For your username, enter your SAN number if you are an agency or your last name if you are an agent. For your password, enter your SAN number. Click “Validate.”
  3. Add your contact information, and click “Next.”
  4. Choose the plan year you’d like to order supplies for, and click “Next.”
  5. Select a state or state, and click “Next.”
  6. Select a county or counties, and click “Next.”
  7. Check the box under the “Select” column for any plan materials you’d like to order, and click “Next.”
  8. Choose the quantity of the items you’d like to order. Click “Next.”
  9. Choose your individual items needed and enter the quantities you need.
  10. Choose your Medicare Supplement items needed, enter the quantities, and click “Next.”
  11. Review your order. If you are satisfied with your order, click “Submit.”
  12. Upon submitting your order, you’ll get 3 notifications.
    • Immediately following your order, you will see the Order Confirmation page letting you know that you have successfully completed your order.
    • You will receive an order confirmation email after your order is submitted. The email will go to the email address provided in the order.
    • Once your order has shipped, you will receive a shipping confirmation email to the email address provided on the order. You will be able to click on the order tracking link to track your order once it’s shipped.
Items Available for You to Order:
  • Enrollment Book, which includes:
    • Scope of Appointment
    • Verification form
    • Business reply envelope
    • Full Application
    • Carbonless receipt
  • Combined Enrollment Book-Pilot, which states only:
    • Summary of Benefits
    • Plan Rating
    • Benefit at a Glance
  • SNP forms-SNP plans only
  • PFFS Leaflet -PFFS plans only
  • Other items that can be ordered separately:
    • POPs
    • Flyers
    • Apps
    • SOAs
    • Sales Presentations
    • Physician Finder Tool
Contact for Inquiries Regarding Ordering Supplies:

For help ordering supplies, you can contact Humana’s Agent Support team at 800-309-3163 or agentsupport@humana.com. They are available Monday through Friday from 8 a.m. to 9 p.m. EST.