The Associate Expert Care Program offered by Edison Healthcare is a benefit included as part of your Humana medical plan—built for the moments that matter most: a difficult diagnosis, a major treatment decision or a surgery recommendation. This isn't a program for everyday healthcare questions. It's how Humana associates get options for their biggest healthcare decisions.

Through the Associate Expert Care Program, eligible members get connected with nationally recognized specialists through Edison Healthcare’s Centers of Excellence for a second medical opinion — at little to no cost*. A dedicated Care Coordinator handles the details from start to finish, so eligible members can focus on their health, not paperwork.

When receiving care through the Associate Expert Care Program, copays, coinsurance, travel expenses (including a travel companion), and most deductibles* will be covered by your Humana medical plan. 

* HDHP plans require members to meet a reduced minimum deductible before the medical plan can cover remaining costs. 

The Associate Expert Care Program is available to eligible members and their covered spouse/partner and dependents when facing one of the covered diagnosis types above.

Eligibility can vary slightly depending on the specific medical plan. For full eligibility details visit EdisonHealthcare.com/Humana.

Every diagnosis below is treated with the same priority and the same level of access:

• Cancer – Adult and Pediatric

• Spine – Spinal fusion, discectomy/microdiscectomy, cervical fusion, artificial disc replacement, and laminectomy

• Heart – Cardiac Surgery

• Orthopedic – Total joint replacement and sports medicine 

• Transplant – All transplant types

• Women’s Health – Hysterectomy and menopause-related care

• Complex Care – Non-chronic complex medical conditions and rare genetic conditions

Other medical conditions and procedures may also be eligible for care through the Associate Expert Care Program — not all diagnoses require a Centers of Excellence referral, and a Care Coordinator reviews each case individually to determine the right next steps.

Once eligibility is confirmed, a dedicated Care Coordinator is available to walk eligible members through the process from start to finish:

1. Connect & Share — Contact Edison Healthcare to be connected with a Care Coordinator, complete patient forms, and gather medical records.

2. Consultation — Connect virtually or in person with a nationally recognized specialist for a second medical opinion, depending on the diagnosis and care needs.

3. Review Options & Next Steps — If treatment or surgery is recommended, a Care Coordinator reviews the options and helps determine the right next steps. The Care Coordinator will walk the member through all necessary forms, coordinate travel and accommodations for the member and a companion, and help ensure the surgical team has received all necessary documentation.

‍When facing a difficult diagnosis or treatment decision, the Associate Expert Care Program can help eligible members move forward with confidence, not confusion. Benefits include:‍ ‍

• ‍Highest-quality outcomes: Edison Healthcare’s Centers of Excellence connect members with nationally recognized specialists. The specialists are chosen specifically for their expertise in the covered diagnoses and delivering the highest-quality patient outcomes.

• ‍Meticulous analysis and diagnosis: Edison Healthcare’s Centers of Excellence use a multi-disciplinary physician approach that delivers meticulous analysis and diagnosis. Members benefit by receiving appropriate treatment plans and proper medication, avoiding unnecessary surgeries, lowering risk, and returning faster to a healthier life.

• Relieved administrative burden: Edison Healthcare’s Care Coordinators handle scheduling, coordination, and all administrative tasks from diagnosis through recovery, relieving members so they can focus on their health — not paperwork.

To learn more about the Associate Expert Care Program, members can contact Edison Healthcare directly by calling 1-866-982-7988 (Mon. – Fri., 7 a.m. – 5 p.m. CT), emailing
EHC@edisonhealthcare.com, or scheduling a 30-minute session here.

Eligible members may also receive a call directly from the Associate Expert Care Program.

The member will receive a secure digital form to be completed online. If the member is unable to fill out the form digitally from their phone or computer, the Care Coordinator can assist with other options. To obtain medical services through the Associate Expert Care Program, the member will need to provide additional medical release forms and any specific forms required for the Center of Excellence.

Medical records are necessary for the medical teams to properly evaluate the member’s current diagnosis and deliver an appropriate treatment plan.  The Care Coordinator will assist in requesting medical records.

When receiving care through the Associate Expert Care Program, copays, coinsurance, travel expenses (including a travel companion) and most deductibles* will be covered by your Humana medical plan.

*High Deductible Health Plans (HDHP) require members to meet a reduced minimum deductible before the medical plan can cover remaining costs.