Humana Dual Fully Integrated (HMO D-SNP) en Illinois

Cobertura

Your Humana Dual Fully Integrated (HMO D-SNP) plan includes medical, pharmacy, vision, behavioral health and hearing coverage. Algunos de nuestros afiliados también pueden afiliarse a nuestros planes especializados o de cuidado a largo plazo para recibir cobertura y beneficios adicionales. Usted elige cómo recibir su atención médica. Con las opciones de atención en persona o por telesalud, mantenerse sano es muy sencillo.

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Cobertura médica

Your Humana Dual Fully Integrated (HMO D-SNP) plan covers many medical services, including:

  • consultas médicas
  • medically necessary health care or surgery services
  • consultation, diagnosis, and treatment by a specialist
  • telehealth services1, including
    • services by primary care providers (PCPs) and specialists
    • individual sessions for mental health specialty services and psychiatric services
    • individual sessions for outpatient substance abuse urgently needed services
  • ¡Y más!

Prior authorization may be required for services. For a full list of covered services, refer to your Manual para afiliados.

Cobertura de salud conductual

Nos asociamos con Carelon Behavioral Health para proveer servicios de salud conductual integrados, tales como:

  • Servicios psiquiátricos
  • Rehabilitación

To access services, visit Carelon Behavioral Health

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Select “Humana FIDE SNP” as your health plan    

Su salud mental es tan importante como su salud física. That is why your Humana Dual Fully Integrated (HMO D-SNP) plan covers comprehensive behavioral health services including:

  • outpatient mental health care services provided by any Illinois Medicaid or Medicare-qualified mental health care professional as allowed under applicable state laws.
  • rehabilitation services recommended by a physician or Licensed Practitioner of the Healing Arts, such as Integrated Assessment and Treatment Planning, crisis intervention, therapy, and case management
  • day treatment services
  • outpatient hospital services, such as Clinic Option Type A and Type B services
  • medically necessary crisis intervention services
  • screening and treatment for substance use disorders
  • ¡Y más!

Prior authorization may be required for services. For a full list of covered services, refer to your Manual para afiliados.

Cobertura de farmacia

Administrar sus medicamentos es importante. The Humana Dual Fully Integrated (HMO D-SNP) plan includes coverage for prescription and over-the-counter medicine. Trabajamos con usted y con su médico para asegurarse de que usted reciba los medicamentos que necesita.

Learn more about your pharmacy coverage

Cobertura de atención médica a largo plazo

If you need long term care, your Humana Dual Fully Integrated (HMO D-SNP) plan has you covered. Your plan includes care in a skilled nursing facility, including:

  • a semi-private room, or a private room if it is medically needed, maintenance and cleaning
  • meals, including special meals, food substitutes, and nutritional supplements
  • nursing services and resident supervision/oversight
  • servicios médicos
  • physical therapy, occupational therapy, and speech therapy
  • drugs, and other medications
  • non-custom durable medical equipment (such as wheelchairs and walkers)
  • medical and surgical supply items (such as bandages, oxygen administration supplies, oral care supplies and equipment
  • ¡Y más!

Prior authorization may be required for services. For a full list of covered services, refer to your Manual para afiliados.

Cobertura de la vista

Your vision is important. Your Dual Fully Integrated (HMO D-SNP) plan plan includes:

  • annual routine eye exams
  • eyeglasses (lenses and frames)
    • frames limited to one pair in a 24-month period
    • lenses limited to one pair in a 24-month period,
  • low vision devices
  • contacts and special lenses when medically necessary, with prior approval
  • ¡Y más!

Prior authorization may be required for services. For a full list of covered services, refer to your Manual para afiliados.

Cobertura dental

Regular dental hygiene can have a big impact on your health and wellbeing. Your Dual Fully Integrated (HMO D-SNP) coverage includes:

  • up to $500 allowance every year for non-Medicare covered preventive and comprehensive dental services. Usted debe pagar cualquier monto que supere el límite de la cobertura dental. Los montos no utilizados a fin de año caducarán.

Su beneficio puede utilizarse para la mayoría de los tratamientos dentales, como estos:

  • Preventive dental services, such as exams and routine cleanings
  • Basic dental services, such as fillings and extractions
  • Major dental services, such as periodontal scaling, crowns, dentures, root canals, and bridges

La asignación no puede utilizarse para fluoruro, servicios cosméticos e implantes.

Certain dental services, including cleanings, fillings, and dentures, are available through the Illinois Medicaid Dental Program.

We pay for some dental services when the service is an integral part of specific treatment of a person’s primary medical condition.

Prior authorization may be required for services. For a full list of covered services, refer to your Manual para afiliados.

Cobertura de audición

Hearing health is important to your overall health and wellbeing. Your Humana Dual Fully Integrated (HMO D-SNP) plan covers many routine hearing services.

We pay for hearing and balance tests done by your provider. These tests tell you whether you need medical treatment. They are covered as outpatient care when you get them from a physician, audiologist, or other qualified provider.

The plan also covers the following:

  • basic and advanced hearing tests
  • hearing aid counseling
  • fitting/evaluation for a hearing aid
  • hearing aids once every three years
  • hearing aid batteries and accessories
  • hearing aid repair and replacement of parts.

In addition, we cover Mandatory Supplemental Hearing Benefits which include a routine hearing exam and hearing aid coverage.

Humana Dual Integrated en Illinois

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