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 2. Legal information
 3. Privacy

 1. Back to Legal information


PRIVACY PRACTICES



The following privacy practices have been updated effective May 2023:

 * HIPAA Privacy Notice: Applies to all entities that are part of the Insurance
   ACE, an Affiliated Covered Entity under HIPAA. The ACE is a group of legally
   separate covered entities that are affiliated and have designated themselves
   as a single covered entity for purposes of HIPAA.
 * State notices: Review notices specific to your state.
 * HIPAA Individual privacy rights: Get details on your privacy rights and
   download forms to exercise your rights.


HIPAA Privacy Notice State notices HIPAA Individual privacy rights


VIEW OUR PRIVACY AND FINANCIAL PRACTICES

Notice of privacy practices – English, PDF (opens in new window)

Notice of privacy practices – Spanish, PDF (opens in new window)

Insurance Ace List, PDF (opens in new window)

Humana has worked throughout the company to ensure compliance with privacy
provisions of the Health Insurance Portability and Accountability Act of 1996
(HIPAA), a federal law designed to ensure the privacy of personal and health
information.

Humana also complies with all state privacy laws, rules, and regulations. In
addition to reviewing the Notice of Privacy Practices, residents of the
following states should review the policies specific to those states.

California: No cost language translation - English, PDF (opens in new window)

New York: Confidentiality for Domestic Violence Victims & Endangered Individuals
Notice - English, PDF (opens in new window)


INDIVIDUAL RIGHTS FORMS

This form grants Humana and its subsidiaries permission to share your
information to a trusted individual(s) that you choose. The form below allows
you to choose the level of information to share with the trusted individual. You
can specify any and all information, information specific to a treatment or
injury, or something different.

Consent for release of protected health information - English, PDF (opens in new
window)

Consent for release of protected health information - Spanish, PDF (opens in new
window)

This form terminates previously granted permission for Humana to release or
disclose a member's protected health information to other individuals named on
the form.

Revocation of consent for release of protected health information - English, PDF
(opens in new window)

Revocation of consent for release of protected health information - Spanish, PDF
(opens in new window)

This form requests a list of disclosures Humana made of a member's protected
health information. Disclosures made for payment and health plan operations are
excluded from this process.

Request for accounting of disclosures - English, PDF (opens in new window)

Request for accounting of disclosures - Spanish , PDF (opens in new window)

This form requests a correction to Humana-created protected health information
that a member feels is inaccurate or incomplete.

Request amendment of your protected health information - English, PDF (opens in
new window)

Request amendment of your protected health information - Spanish, PDF (opens in
new window)

This form requests an inspection or copy of Humana-maintained protected health
information about a member.

Request to access protected health information - English, PDF (opens in new
window)

Request to access protected health information - Spanish, PDF (opens in new
window)

This form requests limitation or restriction of disclosures of a member's
protected health information to others such as a family member, friend, spouse,
doctor, or any other party.

Request for restriction of protected health information - English, PDF (opens in
new window)

Request for restriction of protected health information - Spanish, PDF (opens in
new window)

This form withdraws a previously requested restriction of a member's protected
health information.

Request for restriction termination - English, PDF (opens in new window)

Request for restriction termination - Spanish, PDF (opens in new window)

This form requests that Humana communicate with a member about protected health
information in a different way during life-threatening situations. Examples of
alternate means could include telephone, mail, e-mail, or a different address.

Request for alternate communications - English, PDF (opens in new window)

Request for alternate communications - Spanish, PDF (opens in new window)

This form documents an issue or concern if a member believes his or her privacy
rights may have been violated.

HIPAA privacy complaint form - English, PDF (opens in new window)

HIPPA privacy complaint form - Spanish, PDF (opens in new window)

LEGAL INFORMATION

 * Privacy practices
 * Humana Privacy Policy
 * Disclaimer and licensure
 * Hospital provider notice
 * Special Investigation request to contact
 * Special Investigation request to contact – Spanish
 * Special Investigation referral form
 * Fraud, waste and abuse
 * Accessibility
 * Non-discrimination disclosure
 * Multi-language interpreter support
 * System requirements
 * Marketing practices
 * Protect yourself from healthcare scams



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© Humana 2024
 * Legal
 * Privacy Practices
 * Privacy Policy
 * Your Privacy Choices
 * Site Map
 * Disclaimers & Licensure
 * Fraud, Waste & Abuse
 * Accessibility
 * System Requirements

Last Updated: 10/10/2023