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This page links you to the forms Humana Medicare members need most often.

Appointment of Representative form

Consent for Release of Protected Health Information

Medicare Prescription Drug Claim form

Medical Claim form

Drug coverage determinations

Find out about drug coverage determinations and redeterminations and access our forms.

Medicare Part D Coverage Determination and Redetermination forms

Grievance/Appeal form

Learn more

Have questions?

For benefit, claims and provider questions, call Humana Group Medicare Customer Care at 888-899-5444 (TTY: 711), Monday – Friday, 8 a.m. – 9 p.m., Eastern time (5 a.m. – 9 p.m., Pacific time).

Enroll

For premium, eligibility and enrollment questions, call Disney Benefits Center at 800-354-3970 (TTY: 711), Monday – Friday, 8:30 a.m. – midnight, Eastern time, (5:30 a.m. – 9 p.m. Pacific time), or visit NetBenefits.com. 

MyHumana sign in

Sign in securely to view your account information. Sign in

If you’re new to MyHumana, register by using your Humana ID number or your Medicare number. Register now

All product names, logos, brands and trademarks are property of their respective owners, and any use does not imply endorsement.

Some links on this page may take you to Humana non-Medicare product or service pages or to a different website.

This communication does not guarantee benefits and does not indicate all services received will be covered by your plan. Please refer to your Evidence of Coverage or call Customer Service at the number on the back of your Humana ID card to confirm that the service will be covered by your plan.

This information is provided for educational purposes only. It is not to be used for medical advice, diagnosis or treatment. Consult your healthcare provider if you have questions or concerns.

Go365 is not an insurance product and is not available with all Humana health plans. This is a general description of services which are subject to change. Product features may vary by client. Please refer to Customer Support for more information.

SilverSneakers may not be available on all plans or in all areas.

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