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Individual Privacy Rights

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. This form was last updated in January 2019.

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. This form was last updated in August 2014.

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. This form was last updated in October 2016.

This form requests a correction to Humana-created protected health information that a member feels is inaccurate or incomplete. This form was last updated in October 2016.

This form requests an inspection or copy of Humana-maintained protected health information about a member. This form was last updated in October 2016.

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. This form was last updated in October 2016.

This form withdraws a previously requested restriction of a member's protected health information. This form was last updated in October 2016.

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. This form was last updated in October 2016.

This form documents an issue or concern if a member believes his or her privacy rights may have been violated. This form was last updated in October 2016.

Privacy policies

Notice of Privacy Practices for Medicare, details on your privacy rights and forms to exercise your rights.

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Government health plans

Notice of Privacy Practices for Medicare.

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Communication policies

Select how to receive specific communications.

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Internet privacy statement

Learn and manage your online rights with us.

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