CarePlus Health Plans

CarePlus (a Humana company) Florida Medicare Advantage. Published as the Health Services Department / provider services line for prior authorization questions, Availity help and claim-denial review requests; the PA form lists it as the utilization management provider line for urgent/same-day services. Eligibility and authorization submission are expected through Availity Essentials. Not a member line.

2026 CarePlus health services prior authorization request form fax for requests in Broward and Palm Beach counties. Availity Essentials is the preferred submission route. Use the county-specific fax printed on the current form.

2026 CarePlus health services prior authorization request form fax for Miami-Dade County requests. Availity Essentials is preferred.

2026 CarePlus health services prior authorization request form fax for counties other than Miami-Dade, Broward and Palm Beach.

CarePlus Medicare Part D coverage determination request form (prescriber may submit). Fax and mailing address are printed on the form. Phone requests are directed to the CarePlus member services number on the same form.

Electronic 837 claims via Availity Essentials using CarePlus payer ID 95092 (Availity-specific). Paper claims only if all EDI methods fail and after contacting your provider services executive. Contracted filing limit 180 days; non-contracted 12 months. Written requests to review denied claims go to the same P.O. Box.

Written disputes of an initial claim determination (include provider name, NPI/TIN, member name/ID, date of service, etc. per page). Phone review requests use provider services 866-220-5448.

Availity (third-party portal used by CarePlus) for questions about Availity forms/submission. CarePlus medical payer ID 95092; CarePlus dental claims use Humana Dental payer ID 73288. Availity cannot decide CarePlus coverage.

CarePlus dental benefits are serviced through Humana Dental: electronic dental claims via Availity with payer ID 73288; paper only when EDI fails. Phone is the Humana provider customer service line printed on the CarePlus dental resources page.

Physicians/providers request to join the CarePlus network by faxing the Letter of Interest form. Not for claims or authorizations.

Send address, phone/fax, website or panel-status changes for the CarePlus provider directory to your provider services executive by fax, or call Provider Operations/Provider Services.

Member-facing line shown on CarePlus provider pages (TTY 711). Use provider services for provider questions.