Explore Data Exchange APIs

Browse through our collections to learn about new use cases to implement in your app.

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HL7 FHIR
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CarePlan

View a list of the plans in place for the member's care delivery and condition management.

HL7 FHIR
CareTeam

View a list of the providers and organizations involved in the member's care delivery.

HL7 FHIR
Condition

Record patient details regarding diagnoses, conditions or other medical issues.

HL7 FHIR
Coverage

Pay for health care products or services with insurance or self-payment.

HL7 FHIR
DocumentReference

Clinical notes written by providers regarding a member's health.

HL7 FHIR
Drug Formulary

Humana's Drug Formulary APIs provide a list of medications that are covered by Humana plans.

HL7 FHIR
Explanation of Benefits

Exchanges information about the benefits Humana has provided on behalf of a member.

HL7 FHIR
Goal

View a list of a member's personal health goals.

HL7 FHIR
Immunization

View a comprehensive history of patient immunization records.

HL7 FHIR
InsurancePlan

List of Humana plans and their associated networks.

HL7 FHIR
List

Retrieve information about a given Humana plan and its drug formulary.

HL7 FHIR
Location

Provides location and hours of operation details for healthcare providers.

HL7 FHIR
Medication

Provides relevant details, including codes and names, for a given medication.

HL7 FHIR
MedicationKnowledge

Information about a specific medication as defined by a plan's drug formulary.

HL7 FHIR
MedicationRequest

View medication and/or instruction for administration for inpatient or outpatient care.

HL7 FHIR
Observation

Data pertaining to the member's labs, vitals, and social history.

HL7 FHIR
Organization

Provides details about healthcare organizations (like hospitals and pharmacies).

HL7 FHIR
Patient

Fetch demographics data for a Humana member.

HL7 FHIR
Practitioner

Gives details about individual healthcare providers.

HL7 FHIR
PractitionerRole

Provides resources indicating which providers and organizations are in-network for a given network ID.

HL7 FHIR
Procedure

View details on procedures and long-term services.

HL7 FHIR
Provider Directory

Identify which providers and pharmacies are in-network for a given Humana insurance plan.

HL7 FHIR
CATEGORY
Agent
2
Enrollment
Individual Dental and Vision (IDV) Enrollment API

This API is intended for the submission of Individual Dental and Vision (IDV) enrollment applications.
Medicare Enrollment API

This API is intended for the submission of Medicare enrollment applications.
Medicare Enrollment Tracking and Reporting API

Reporting API for enrollment data, including but not limited to Agent, enrollment member status.
Medication List API

The Medication List resource enables the user to pass to Humana the medication list reviewed in the pricing experience and receive a unique token in return to accompany the related enrollment application.
Plan Info API V2

The Plan Info API retrieves (plan benefit, plan info, plan rate) pricing information for different Humana plans, such as Medicare Advantage, PDP, IDV, and OSB.