How to File a Grievance Against Humana PPO

Humana is a health insurance company that offers health insurance plans to a variety of individuals, including seniors and members of the military. Those with a Humana PPO can seek health care from health care professionals who participate with Humana. Different PPO plans exist with Humana. The 90/60 plan, for example, covers 90 percent of costs for services provided by Humana-participating physicians and 60 percent of out-of-network care. If you have a problem with your Humana PPO, file a grievance with Humana's Service Center.

Things You'll Need

• Pen and paper or word processing program and printer
• Supporting evidence
• Envelope and stamp

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Instructions

• 1

  Address a letter to "Humana Grievances and Appeals." Write "To whom it may concern at Humana Grievances and Appeals."

• 2

  Include your name, address, telephone number, and Humana ID number in the first paragraph of the letter.

• 3

  Describe the reason for your grievance in the second paragraph of your letter. Grievance grounds include denial of covered services, being overcharged or unexpected losing coverage.

• 4

  Include any notes or documents that support your grievance (such as copies of letters sent by Humana explaining denied coverage).

• 5

  Send the letter to:

  Humana Grievances and Appeals
  P.O. Box 14546
  Lexington, KY 40512-4165

  Alternatively, file a verbal grievance by calling 800-457-4708.