Independent profile. Not owned, sponsored or endorsed by Humana.

Humana Reviews, Complaints & Contacts

Humana Inc. is a Louisville, Kentucky health insurer and healthcare services company (NYSE: HUM) with about 15 million medical-plan members, including about 5.2 million individual Medicare Advantage members, according to its 2025 annual report. Medicare members who disagree with a denied claim or service can appeal to Humana within 65 days of the decision; problems with service or quality of care go to Humana as a grievance or to Medicare. Humana is a defendant in a pending Justice Department False Claims Act case over broker payments, which it disputes, and in private class actions.

REVIEWS & COMPLAINTS62on USAComplaints · none in last 3 yrs · latest 2013
WEBSITEhumana.com
HEADQUARTERSLouisville, KY
PROFILE CHECKED2026-11-05
Submit a Complaint Read reviews & complaints ↓ Official website ↗
VERIFIED

Contacts

PhoneAddress

Customer service & general contact

Show all 16 contacts

Customer service & general contact (continued)

Account & login

Fax & written correspondence

  • Appeals by fax: medical services1-800-949-2961
  • Appeals by fax: medications1-877-556-7005

Corporate & press

Other contacts

VERIFIED

Locations

  • Headquarters101 East Main Street Louisville KY 40202
  • Mailing addressHumana Grievances and Appeals, P.O. Box 14165 Lexington KY 40512-4165
EDITORIAL

Company Information

BBB, Trustpilot

Legal name
Humana Inc.
Founded
1961
Business type
Health insurance and healthcare services company (Medicare Advantage, Medicare Part D, Medicare supplement, Medicaid, TRICARE, dental and vision, and CenterWell pharmacy, primary care and home health services); NYSE: HUM
Website
humana.comSource: Humana Contact us page, checked 2026-10-27
Headquarters
Louisville, KYSource: Humana Form 10-K for 2025, principal executive offices, checked 2026-10-27

Humana Inc. is a publicly traded company (NYSE: HUM) that files annual and quarterly reports with the U.S. Securities and Exchange Commission; its annual report for 2025 was filed on February 19, 2026 and its latest quarterly report on July 29, 2026. Those filings describe Medicare Advantage and Part D contracts with CMS, Medicaid contracts with states and TRICARE work for the Defense Department. Its Medicare plans are contracted with and overseen by CMS, and its insurance subsidiaries are licensed and supervised by state insurance departments.

In short, Humana is a large, licensed and federally contracted insurer. That alone says nothing about how well it handles a given claim: BBB rates Humana A+ and lists it as accredited since 1998, while BBB and Trustpilot also show many customer complaints and low review averages, as set out on this page. The government case and the private lawsuits against Humana are summarized in the Lawsuits section.

EXTERNAL SOURCE

Independent Sources

Shown for context — not merged with USAComplaints' own numbers.

BBBComplaints in the last 3 years
306 reviews · 304 complaints · BBB business grade A+ · average customer rating 1.15 / 5
TrustpilotAll reviews on an unclaimed profile
435 reviews · TrustScore 1.4 / 5
EDITORIAL

Complaint Themes

Claim denied, or refusal to pay or cover describedAgent, sales or misleading-statement allegationsCancellation, disenrollment, refund or terminationPrescriptions, formulary, co-pay or Part DDental plan complaints

Themes summarize what people write about most often. One complaint can touch several themes, and some complaints (a positive report, or one later retracted by its author) fit none, so themes are not a count of complaints.

CONSUMER ALLEGATION

Reviews & Complaints on USAComplaints

USAComplaints currently maintains 62 historical complaints about Humana, published between 2005 and 2013. No approved complaints have been published on this site during the last three years. For a current reputation snapshot, see the independent sources on this page.

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EDITORIAL

Complaint record: BBB, Trustpilot and this site's archive

BBB. BBB's headquarters profile for Humana, Inc. in Louisville rates the company A+ and shows it as BBB Accredited since September 17, 1998. It lists 304 complaints in the last 3 years and 91 in the last 12 months. By BBB's own complaint types, billing issues are the largest group (142), followed by customer service (72), service or repair (39) and product issues (31); smaller groups cover delivery, sales and advertising, and orders. BBB marks 240 of the complaints as answered and 64 as resolved. Separately, customer reviews on BBB average 1.15 out of 5 from 306 reviews; BBB says customer reviews are not used in its letter grade. The complaints are consumers' own accounts, and the letter grade, the complaint counts and the review average are different measures.

Trustpilot. Humana's Trustpilot profile for www.humana.com is unclaimed and shows a TrustScore of 1.4 out of 5 from 435 reviews, 235 of them from the last 12 months. Trustpilot notes that Humana has not invited customers to leave reviews, so the reviews may not be representative.

This site's archive. 62 published complaint reports are linked to this profile. They were posted between 2005 and 2013 and are the writers' own accounts, not findings. The most common subjects are claims that were denied or not paid; cancellation, disenrollment, refunds and terminated coverage; agents, sales calls and statements the writer calls misleading; prescriptions, formularies, co-pays and Part D; and dental plans.

Had an experience with Humana? Tell other people what happened.

Submit a Complaint
EDITORIAL

Humana complaints, appeals and grievances: what to do

Most steps on this page apply to Humana Medicare plans; employer, individual, dental and vision plans are covered at the end. The denial notice and the Evidence of Coverage for your own plan set the exact rules and deadlines, so keep them at hand. This is general information, not legal or medical advice.

Appeal a denied claim, service or prescription. Medicare calls this an appeal: use it when a plan refuses to cover a service, supply or prescription, or bills you for a claim you already submitted. Humana gives Medicare members up to 65 days from the initial determination or claim denial date to request an appeal; after 65 days you must show good cause.

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You can file online on Humana's complaint and appeal page, or fill in Humana's Medical Service Appeal Request Form (English or Spanish) and send it by mail to Humana Grievances and Appeals, P.O. Box 14165, Lexington, KY 40512-4165, or by fax to 1-800-949-2961 for medical services or 1-877-556-7005 for medications. Include your member ID, the denial notice and any supporting letter or records from your doctor. If someone is filing for you, Humana links Medicare's Appointment of Representative form (CMS-1696).

Fast (expedited) appeals. Humana accepts an expedited appeal when the issue is continued coverage of an inpatient stay, or when waiting for a standard decision could seriously jeopardize the member's life, health or ability to regain maximum function.

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Call 1-800-867-6601 (TTY 711), Monday to Friday, 8 a.m. to 8 p.m. Eastern. A request is not eligible for an expedited response if the member has already received the denied medication or service.

If Humana upholds the denial. Under Medicare's rules for Medicare Advantage medical services, the plan decides a standard pre-service appeal within 30 days, a payment appeal within 60 days and a fast appeal within 72 hours. If the plan keeps its denial, the case goes automatically to an Independent Review Entity; you do not need to file again. Further levels are an Office of Medicare Hearings and Appeals hearing (minimum amount in dispute $200 for 2026), the Medicare Appeals Council and federal district court (minimum $1,960 for 2026), each requested within 60 days of the previous decision. A drug covered under Part B, such as one given in a doctor's office, has a shorter clock: the plan must decide a standard appeal within 7 calendar days.

Prescription drug (Part D) denials. First ask Humana for a coverage determination, or an exception if the drug is not on Humana's Drug List or you want a limit waived; your prescriber's supporting statement helps. If Humana says no, you have 65 days from the date of its Notice of Denial of Medicare Prescription Drug Coverage to ask for a redetermination, using Humana's Request for Redetermination form, by fax to 1-877-556-7005 or by calling the number on your member card. Humana must decide a standard redetermination within 7 calendar days, a request to be repaid for a drug you already bought within 14 days, and a fast one within 72 hours. Unlike medical appeals, a Part D denial is not forwarded automatically: if Humana keeps it, you must ask the Independent Review Entity for a reconsideration in writing within 60 days of receiving the decision; the address is in Humana's letter.

Complaint (grievance) about service or quality of care. A grievance covers dissatisfaction with how Humana or its providers operate or treat you, rather than a coverage decision. File it with Humana orally, by calling the number on your member card, or in writing through the same complaint and appeal page, no later than 60 days after the event. Under federal Medicare rules Humana must answer within 30 days, which it can extend by up to 14 days, and within 24 hours if the complaint is about its refusal to fast-track an appeal or its decision to take extra time on one.

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For a quality-of-care problem you can also send a written complaint to the Quality Improvement Organization for your state. You can also complain to Medicare with the online Medicare Complaint Form or by calling 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048), available 24 hours a day except some federal holidays. Medicare says some complaints can be filed anonymously and that a family member or friend can help if you appoint them as your representative.

Free help. Your State Health Insurance Assistance Program (SHIP), listed at shiphelp.org, gives free, personalized counseling on Medicare plans, appeals and switching plans.

Leaving or switching a Humana Medicare plan. You can change or drop a Medicare Advantage or drug plan only in set periods: Open Enrollment from October 15 to December 7, with the new coverage starting January 1; the Medicare Advantage Open Enrollment Period from January 1 to March 31, when people already in a Medicare Advantage plan can switch plans or return to Original Medicare; and Special Enrollment Periods for certain life events.

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Enrolling in a new plan generally ends the old one automatically. You can also call 1-800-MEDICARE or ask the plan for a written disenrollment form, which the plan must receive before your enrollment period ends. Humana says to send a completed form or your own signed request to Humana Inc., Attention: Disenrollment, P.O. Box 14168, Lexington, KY 40512-4168, or by fax to (800) 633-8188. Before a plan's effective date, you can cancel by calling Humana Customer Care at (800) 285-7197 (TTY 711) or in writing. Humana's Medicare line is 800-457-4708 (TTY 711), Monday to Friday, 8 a.m. to 8 p.m. local time.

Medicaid members. Humana's appeal page has a separate Medicaid tab: Medicaid members have up to 60 days from the initial determination or claim denial date to appeal, mail goes to Humana Grievances and Appeals, P.O. Box 14546, Lexington, KY 40512-4546, and each state has its own phone line.

Other contacts. Humana offers online chat through a signed-in MyHumana account and replies on X at @HumanaHelp from 6 a.m. to 8 p.m. Eastern. Individual dental and vision plan members can call 877-877-1051, Monday to Friday, 8 a.m. to 9 p.m. Eastern.

Employer, individual, dental and vision plans. For coverage that is not Medicare or Medicaid, the appeal deadline is in your plan documents and the denial letter; federal rules give members of employer group health plans at least 180 days from the denial notice to file an internal appeal.

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Humana Employer plan grievances and appeals go to Humana Grievances and Appeals, P.O. Box 14546, Lexington, KY 40512-4546, or to the Customer Care number on your member card. If the internal appeal fails, you can usually ask for an independent external review. For an individual plan or an insured employer plan, the regulator to complain to is your state insurance department; for a self-funded employer plan it is the U.S. Department of Labor's Employee Benefits Security Administration, 1-866-444-3272.

Complaints through BBB. Humana's BBB profile explains that federal health privacy law (HIPAA) prevents Humana from sharing details of a consumer's health issues with BBB unless the complaint includes a HIPAA-compliant authorization; without one, Humana contacts the consumer directly.

EDITORIAL

Government and regulatory matters disclosed in Humana's SEC filings

Humana describes these matters in its annual report for 2025 and its quarterly report for the period ended June 30, 2026. Allegations are not findings.

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Justice Department information requests on risk adjustment. Humana says the Civil Division of the U.S. Department of Justice has sent it information requests about its Medicare Part C risk adjustment practices, including its oversight of provider-generated data and related business and compliance practices, and that it continues to cooperate. Risk adjustment is the system that raises or lowers Medicare's payment for each Medicare Advantage member according to the diagnoses on record.

Justice Department False Claims Act complaint. On May 1, 2025 the United States filed a complaint in partial intervention in United States ex rel. Shea v. eHealth, Inc., et al. in the District of Massachusetts. It alleges that Aetna, Elevance Health and Humana paid kickbacks to the brokers eHealth, GoHealth and SelectQuote for Medicare Advantage enrollments and that Aetna and Humana conspired with the brokers to discriminate against beneficiaries with disabilities. The Justice Department says these are allegations only, with no determination of liability; Humana says it will vigorously defend. The court's March 2026 ruling and the current status are in the Lawsuits section.

State and other regulators. Humana says its business practices are reviewed by state insurance and health care regulators and other authorities on matters such as claims payment, utilization management, sales practices and access to care, that some of these reviews have historically resulted in fines, and that some have required changes to its practices. The filings do not name the specific matters, amounts or dates.

Humana as plaintiff. Humana has also sued the federal government over the Medicare Advantage audit rule and over its Star Ratings; both cases are in the Lawsuits section.

EDITORIAL

Lawsuits involving Humana

Court records

Large insurers are sued regularly and also sue regulators. The main cases involving Humana are on this page; allegations are not findings, and pending cases can end in dismissal, settlement or judgment for either side.

United States ex rel. Shea v. eHealth, Inc., et al. (U.S. District Court, District of Massachusetts, No. 1:21-cv-11777). A former eHealth employee filed this False Claims Act whistleblower case in 2021, and on May 1, 2025 the United States filed its own complaint in partial intervention. The Justice Department alleges that from 2016 through at least 2021 Aetna, Elevance Health and Humana paid kickbacks to the brokers eHealth, GoHealth and SelectQuote in exchange for Medicare Advantage enrollments, and that Aetna and Humana each conspired with the brokers to discriminate against Medicare beneficiaries with disabilities whom, in the government's account, they perceived as less profitable. The Department says the claims are allegations only and that there has been no determination of liability. Humana says the case concerns non-commission payments to three call-center broker partners and its marketing to beneficiaries under 65, and that it will vigorously defend. On March 25, 2026 Chief Judge Denise J. Casper largely denied the defendants' motion to dismiss the government's complaint, dismissing only an unjust-enrichment claim; at that stage a court assumes the allegations are true and decides only whether they state a legal claim. On June 23, 2026 the whistleblower dropped his own remaining claims that the government had not joined, so the case goes forward on the government's complaint. It is pending.

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Elliot v. Humana, Inc. (U.S. District Court, Western District of Kentucky, No. 3:22-cv-00329). David Elliot alleges that Humana kept placing prerecorded calls to his number after being told it had reached the wrong person, in violation of the Telephone Consumer Protection Act, the federal law that restricts automated and prerecorded calls. On April 9, 2025 the court certified a class of people who received such wrong-number calls, and on December 30, 2025 the Sixth Circuit denied Humana's petition for permission to appeal that order, so the class action proceeds. There is no ruling on the merits, and Humana says it will vigorously defend.

Barrows v. Humana, Inc. (U.S. District Court, Western District of Kentucky, No. 3:23-cv-00654, filed December 12, 2023). Medicare Advantage members and the estate of a member allege, in a proposed class action, that Humana used an artificial-intelligence model called nH Predict to deny or cut short coverage of post-acute care such as skilled nursing stays. Humana denies this and says such decisions are made case by case by physician medical directors under Medicare's coverage rules. On August 14, 2025 Judge Rebecca Grady Jennings let the claims for breach of contract, breach of the implied covenant of good faith and fair dealing, unjust enrichment and common-law fraud go forward and dismissed four North Carolina statutory and insurance bad-faith claims with prejudice. No class has been certified, and the case is pending.

United States ex rel. Scott v. Humana Inc. (U.S. District Court, Western District of Kentucky, No. 3:18-cv-00061). Steven Scott, a former Humana actuary, alleged that Humana's Medicare Part D bids for 2011 through 2017, centered on its Walmart-branded drug plan, used cost assumptions that differed from its internal estimates, so that the government paid more than it should have. The Justice Department did not intervene. Humana argued that its bid figures were estimates of future costs, not false statements. The case was set for trial and settled just before it began: as announced on August 16, 2024, Humana agreed to pay $90 million to the federal government. In September 2025 the court ordered Humana to pay the relator's lawyers about $27.9 million in fees plus about $2.7 million in costs and expenses.

Humana v. Becerra, on appeal as Humana v. Kennedy (U.S. District Court, Northern District of Texas, No. 4:23-cv-00909; Fifth Circuit No. 25-11293). Humana sued the Department of Health and Human Services in September 2023 over the final rule on risk adjustment data validation (RADV) audits, which CMS uses to check Medicare Advantage payments and recover overpayments. On September 25, 2025 the court granted Humana summary judgment and vacated the rule as procedurally invalid under the Administrative Procedure Act. The government appealed on November 21, 2025; a Fifth Circuit panel heard argument on October 5, 2026, and no decision has been issued.

Star Ratings suit. On October 18, 2024 Humana sued HHS and CMS in the Northern District of Texas over how CMS calculated its 2025 Medicare Advantage Star Ratings. On October 14, 2025 the court rejected the challenge; Humana appealed on November 25, 2025, and the appeal is pending in the Fifth Circuit.

Securities and shareholder suits. A proposed stockholder class action filed in June 2024 in the District of Delaware, In re Humana Inc. Securities Litigation, alleges misleading statements between July 2022 and October 2024 about financial performance, medical costs, Star Ratings and certain Medicare Advantage distribution relationships. Related shareholder derivative suits are pending in the Western District of Kentucky and in Kentucky state court. These are investor cases, not disputes over member claims.

PUBLIC RECORD

Court & Public Records

United States ex rel. Shea v. eHealth, Inc., et al. (Humana Inc. a defendant)

Filed

U.S. District Court for the District of MassachusettsDocket 1:21-cv-11777-DJCSource ↗

Filed — no final outcome recorded

It is pending.

Case details: United States ex rel. Shea v. eHealth, Inc., et al. (Humana Inc. a defendant)Show less

False Claims Act whistleblower (qui tam) case first brought by a former eHealth employee. The United States filed its own complaint in partial intervention on May 1, 2025. The Justice Department alleges that Aetna, Elevance Health and Humana paid kickbacks to the brokers eHealth, GoHealth and SelectQuote in exchange for Medicare Advantage enrollments, and that Aetna and Humana each conspired with the brokers to discriminate against Medicare beneficiaries with disabilities; it says the claims are allegations only and that there has been no determination of liability. Humana describes the case as concerning non-commission payments to three call-center broker partners and its marketing of Medicare Advantage plans to beneficiaries under 65, and says it will vigorously defend. On March 25, 2026 Chief Judge Denise J. Casper largely denied the defendants' motion to dismiss the government's complaint, dismissing only an unjust-enrichment claim; at that stage the court assumes the allegations are true. On June 23, 2026 the relator voluntarily dismissed his remaining claims that the government had not joined, so the case continues on the government's complaint.

Elliot v. Humana, Inc.

Filed

U.S. District Court for the Western District of KentuckyDocket 3:22-cv-00329Source ↗

Filed — no final outcome recorded

Humana says it will vigorously defend the case.

Case details: Elliot v. Humana, Inc.Show less

Class action under the Telephone Consumer Protection Act, the federal law that restricts automated and prerecorded calls. Plaintiff David Elliot alleges that Humana kept placing prerecorded calls to his number after being told it had reached the wrong person. On April 9, 2025 the district court certified a class of recipients of such wrong-number calls, and on December 30, 2025 the Sixth Circuit denied Humana's petition for permission to appeal that order, so the class action proceeds in the Western District of Kentucky. There is no ruling on the merits.

Barrows v. Humana, Inc.

Filed

U.S. District Court for the Western District of KentuckyDocket 3:23-cv-00654Source ↗

Filed — no final outcome recorded

No class has been certified; the case is pending.

Case details: Barrows v. Humana, Inc.Show less

Putative class action by Medicare Advantage members and an estate alleging that Humana used an artificial-intelligence model, nH Predict, to cut off coverage of post-acute care such as skilled nursing stays. Humana denies the allegations and says denials of post-acute care are made individually by physician medical directors under Medicare's coverage criteria, not by the model. On August 14, 2025 Judge Rebecca Grady Jennings granted Humana's motion to dismiss in part: claims for breach of contract, breach of the implied covenant of good faith and fair dealing, unjust enrichment and common-law fraud may proceed, and four North Carolina statutory and insurance bad-faith claims were dismissed with prejudice.

Humana Inc. and Humana Benefit Plan of Texas, Inc. v. Becerra (RADV rule); appeal Humana v. Kennedy

Appeal decided

U.S. District Court for the Northern District of Texas; appeal U.S. Court of Appeals for the Fifth CircuitDocket 4:23-cv-00909; 5th Cir. 25-11293Source ↗

Appeal decided

The government appealed on November 21, 2025; a Fifth Circuit panel heard oral argument on October 5, 2026, and the appeal is pending.

Case details: Humana Inc. and Humana Benefit Plan of Texas, Inc. v. Becerra (RADV rule); appeal Humana v. KennedyShow less

Humana, as plaintiff, challenged the 2023 final rule on risk adjustment data validation (RADV) audits, under which CMS audits Medicare Advantage payments and can recover overpayments. On September 25, 2025 the district court granted Humana summary judgment and vacated the rule as procedurally invalid under the Administrative Procedure Act.

Humana Inc. and Americans for Beneficiary Choice v. HHS and CMS (Star Ratings)

Appeal decided

U.S. District Court for the Northern District of Texas; appeal Fifth CircuitSource ↗

Appeal decided

Humana's own filings say there is no assurance it will prevail.

Case details: Humana Inc. and Americans for Beneficiary Choice v. HHS and CMS (Star Ratings)Show less

Humana, as plaintiff, challenged how CMS calculated the 2025 Medicare Advantage and Part D Star Ratings. On October 14, 2025 the district court rejected the challenge. Humana appealed on November 25, 2025, and the appeal is pending in the Fifth Circuit.

United States v. Humana Inc. (relator Steven Scott)

Settled

U.S. District Court for the Western District of KentuckyDocket 3:18-cv-00061Source ↗

Settled

In September 2025 the court ordered Humana to pay the relator's lawyers about $27.9 million in attorneys' fees plus about $2.7 million in costs and expenses.

Case details: United States v. Humana Inc. (relator Steven Scott)Show less

False Claims Act whistleblower case brought by Steven Scott, a former Humana actuary, who alleged that Humana's Medicare Part D bids to CMS for 2011 through 2017, centered on its Walmart-branded drug plan, used cost assumptions that differed from its internal estimates. The Justice Department did not intervene. Humana argued in court that its bid figures were estimates of future costs, not false statements. Just before trial Humana agreed to pay $90 million to the federal government, as announced by the relator's lawyers on August 16, 2024.

In re Humana Inc. Securities Litigation

Allegation

U.S. District Court for the District of DelawareSource ↗

Allegation only — no filing confirmed

This is an investor case, not a dispute over member claims.

Case details: In re Humana Inc. Securities LitigationShow less

Putative stockholder class action filed in June 2024 against Humana and certain current and former executive officers under the federal securities laws. It alleges misleading statements between July 2022 and October 2024 about financial performance, medical costs, Star Ratings and certain Medicare Advantage distribution relationships, and seeks unspecified damages. Related shareholder derivative suits, filed between July 2024 and March 2025, are pending in the Western District of Kentucky and in Kentucky state court.

EDITORIAL

Who is Humana? Companies, products and scale

Humana Inc. is a publicly traded Delaware corporation, organized in 1964, with principal executive offices at 101 East Main Street, Louisville, Kentucky 40202; its stock trades on the New York Stock Exchange as HUM. BBB gives the business a start year of 1961. Humana reports two segments, Insurance and CenterWell. At December 31, 2025 it had about 15 million members in its medical benefit plans and 4.7 million in specialty products, including about 5.2 million individual Medicare Advantage members, roughly 1.0 million of them in Florida.

Its insurance products include individual and group Medicare Advantage plans, stand-alone Medicare Part D prescription drug plans, Medicare supplement coverage, state Medicaid contracts, dental and vision plans, and administrative services for the Defense Department's TRICARE program, in which it has taken part since 1996. The CenterWell segment runs CenterWell Pharmacy, including mail-order pharmacy, CenterWell Primary Care clinics and CenterWell Home Health.

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On October 13, 2026 Humana reported a new joint venture with funds managed by HPS Investment Partners, a BlackRock subsidiary, to manage and operate CenterWell Senior Primary Care clinics; it replaces existing joint ventures with funds affiliated with Welsh, Carson, Anderson & Stowe. Medicare's star rating for a specific Humana plan is shown in the plan finder on Medicare.gov.

VERIFIED

Company Relationships

  • Affiliated withCenterWell Pharmacy, Inc.
  • Affiliated withWelsh, Carson, Anderson & Stowe
  • Affiliated withHPS Investment Partners (BlackRock)
EDITORIAL

Frequently Asked Questions

How do I appeal a Humana Medicare claim or coverage denial?

Request the appeal within 65 days of the initial determination or claim denial date; after that Humana requires good cause. File online on Humana's complaint and appeal page, mail an appeal form to Humana Grievances and Appeals, P.O. Box 14165, Lexington, KY 40512-4165, or fax it to 1-800-949-2961 for medical services or 1-877-556-7005 for medications. For an urgent case call 1-800-867-6601 (TTY 711), Monday to Friday, 8 a.m. to 8 p.m. Eastern. If Humana keeps a denial of a medical service, the case goes automatically to an Independent Review Entity. For a prescription drug (Part D) denial, Humana decides a standard redetermination within 7 days; if it keeps the denial, you must ask the Independent Review Entity yourself within 60 days.

How do I file a complaint about my Humana Medicare plan?

For problems with service or the quality of care, file a grievance with Humana through its complaint and appeal page or the number on your member card within 60 days of the event; under Medicare rules Humana must answer within 30 days, or up to 14 days later if it extends the deadline. You can also complain to Medicare with the online Medicare Complaint Form or by calling 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048). A refusal to cover a service or prescription is handled as an appeal, not a complaint.

What is the difference between an appeal and a complaint (grievance) with a Medicare plan?

A complaint, also called a grievance, is about the quality of care or how a plan or its providers treat you. An appeal challenges a coverage decision: a plan's refusal to cover a service, supply or prescription, or a bill for a claim you already submitted. Appeals have strict deadlines, 65 days from the denial for Humana Medicare members, so file the appeal first if a denial is involved.

How many complaints does Humana have on BBB?

BBB's profile for Humana, Inc. in Louisville lists 304 complaints in the last 3 years and 91 in the last 12 months; billing issues are the largest category. BBB rates Humana A+ and lists it as accredited. Customer reviews on BBB average 1.15 out of 5 from 306 reviews, and BBB does not use them in the letter grade.

Is Humana involved in lawsuits with the federal government?

The Justice Department is suing Humana, Aetna, Elevance Health and three brokers in federal court in Massachusetts under the False Claims Act, alleging kickbacks to brokers for Medicare Advantage enrollments and, for Aetna and Humana, discrimination against beneficiaries with disabilities. These are allegations; Humana says it will vigorously defend, and in March 2026 the court let most of the claims proceed. In 2024 Humana paid $90 million to settle a whistleblower case over its Part D bids. Humana has also sued HHS over the Medicare Advantage audit rule, which a court vacated in 2025, and over its 2025 Star Ratings; both are on appeal.

Who owns Humana and where is it based?

Humana Inc. is a publicly traded Delaware corporation owned by its shareholders; its stock trades on the New York Stock Exchange as HUM. Its principal executive offices are at 101 East Main Street, Louisville, Kentucky 40202, and the corporate switchboard is (502) 580-1000, which is not a member-service line.

How many members does Humana have?

At December 31, 2025 Humana had about 15 million members in its medical benefit plans and 4.7 million in specialty products such as dental and vision, according to its annual report. About 5.2 million of the medical members were in individual Medicare Advantage plans.

What do older complaints about Humana on this site say?

62 published complaint reports are linked to this profile. They were posted between 2005 and 2013 and are the writers' own accounts. The most common subjects are denied or unpaid claims, followed by cancellation, disenrollment or refunds, sales agents and statements the writer calls misleading, and prescription coverage. They are not findings and are not added to the BBB or Trustpilot figures.

How do I sign in to MyHumana or get my Humana ID card?

Members sign in at account.humana.com. Humana says that within 10 business days of enrollment you can view, print, email or order your ID card in the ID Card Center or the MyHumana Mobile app, and that your plan start date is on the front of the card.

What is a Humana Gold Plus plan?

Humana Gold Plus is a Medicare Advantage HMO. Humana says that with an HMO plan you can choose a primary care physician from its network, who helps manage your care and provides referrals. It says these plans include the benefits of Medicare Parts A and B, most include prescription drug coverage, and they have an annual out-of-pocket maximum. Costs and benefits depend on your county, so check the plan's Summary of Benefits.

When can I change my Humana Medicare plan for 2027?

Medicare Open Enrollment runs October 15 to December 7, 2026, and changes take effect January 1, 2027. From January 1 to March 31, people already in a Medicare Advantage plan can switch to another Medicare Advantage plan or return to Original Medicare.

What are Humana's 2027 Medicare Star Ratings?

Humana says 95% of its Medicare Advantage members are in plans rated 4.0 stars or above by CMS for 2027, and 42% are in 4.5-star plans. It lists six Medicare Advantage contracts rated 4.5 stars and 12 rated 4.0 stars. These are Humana's own figures; the rating of a specific plan is in the plan finder on Medicare.gov.

What changes for Humana Part D drug plans in 2027?

Humana says yearly out-of-pocket costs for covered Part D drugs are capped at $2,400 in 2027, up from $2,100 in 2026; after that you pay nothing for covered Part D drugs for the rest of the plan year. It also says the federal Part D Premium Stabilization Demonstration will expire.

CONSUMER ALLEGATION

Related Complaints

Names this company in a role other than the primary subject — not necessarily current or complete.