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Humana

Frequently Asked Questions

Why should I choose the KelseyCare | Humana plan and Kelsey-Seybold Clinic for my medical care?

If you're interested in getting greater value, quality healthcare, and excellent customer service, you should consider joining the KelseyCare | Humana health plan, delivered together with Kelsey-Seybold Clinic — a medical organization with a national reputation for clinical excellence and customer satisfaction. And the KelseyCare | Humana plan is easy to use, offering lots of conveniences. You can visit any Kelsey-Seybold physician at any of Kelsey-Seybold's locations throughout the Greater Houston area. You can choose from more than 450 Kelsey-Seybold physicians with no referral required and 24 premier locations offering physician care, lab and X-ray services, advanced imaging, or on-site pharmacies. Conveniences include same-day and next-day In-Person appointments and Video Visits with primary care physicians; 24/7 appointment scheduling with knowledgeable, Houston-based appointment representatives; the reassurance of our After-Hours Nurse Hotline at 713-442-0000, the ability to email your doctor's office and schedule appointments online; and Saturday appointments at regional locations. Click here to view our video to learn more about Kelsey-Seybold Clinic.

Is there a specific geographic area I must live in to join the KelseyCare | Humana plan?

Yes, and it covers most of the Greater Houston-Galveston area. Specifically, the KelseyCare service area includes all ZIP codes in Harris, Fort Bend, Brazoria, Galveston, and Montgomery counties. It also includes select ZIP codes in Galveston, Brazoria, and Chambers counties. ZIP codes are as follows: 77510, 77517, 77518, 77539, 77546, 77549, 77563, 77565, 77568, 77573, 77574, 77590, 77591, 77592, 77422, 77430, 77431, 77463, 77480, 77486, 77511, 77512, 77515, 77516, 77531, 77534, 77541, 77542, 77566, 77577, 77578, 77581, 77583, 77584, 77588, 77301, 77302, 77303, 77304, 77305, 77306, 77316, 77318, 77333, 77353, 77354, 77355, 77356, 77357, 77362, 77365, 77372, 77378, 77380, 77381, 77382, 77384, 77385, 77386, 77387, and 77393. View the full listing of ZIP codes in the Service Area Map

Who should I contact if I have KelseyCare | Humana medical benefits and claims questions?

You will continue to direct benefit and claim questions to the Humana Customer Service unit at the phone number shown on your Member ID card. You will call the KelseyCare Concierge at 713-442-9593 for personalized assistance in choosing Kelsey-Seybold doctors and getting answers to all your questions about Kelsey-Seybold.

Will I continue to have access to the Humana 24/7 Health Information Line to speak with a nurse when needed?

Yes. Call the Humana Health Information Line at the phone number shown on your Member ID card to speak with a nurse when needed. As a KelseyCare member, you also have access to the Kelsey-Seybold 24-hour Contact Center at 713-442-0000, and the Kelsey-Seybold After-Hours Nurse Team. The Kelsey-Seybold After-Hours Nurse Team is staffed by Kelsey-Seybold registered nurses who can access your secure electronic medical record (EMR) and page your Kelsey-Seybold physician when needed. You can also call the After-Hours Nurse Hotline at any time after normal business hours to ask questions or discuss concerns regarding symptoms or illnesses you or a family member may be experiencing.

Will I continue to have access to Humana.com?

Yes. You have access to both Humana.com and Kelsey-Seybold.com for information. We encourage you to continue to visit Humana.com to access your Health Assessment, claims, explanations of benefits (EOBs), plan documents, coordination of benefits (COB) forms, and to learn about Humana discount programs and more. You can also access Kelsey-Seybold physician biographies and videos, MyKelseyOnline, and information about Kelsey-Seybold at Kelsey-Seybold.com

Will my healthcare providers continue to file my claims with Humana or with Kelsey-Seybold?

For questions about claims, please contact Humana customer service at the number indicated on the back of your card. You may also contact the KelseyCare | Humana Concierge at 713-442-9593.

What if I become ill or injured and I'm out of the Houston area?

Emergencies are covered nationwide. Contact Humana at the phone number shown on your Member ID card for more information about participating urgent care centers outside of the Greater Houston area. After receiving care, you must notify your Kelsey-Seybold doctor as soon as possible. Please note that in the KelseyCare | Humana plan, when you are traveling out of the area, appointments with a doctor in the doctor's office are not covered without prior authorization from Kelsey-Seybold. Emergency Care nationwide, and urgent care at in-network urgent care centers in the Greater Houston area is a covered benefit.

What if I am currently under treatment with a non-participating physician at the time I switch to the KelseyCare | Humana Plan?

If you are currently undergoing treatment for a serious medical condition and want to enroll in the KelseyCare | Humana plan, please complete a Transition of Care form or contact your insurance company's Customer Service Line at the phone number shown on your Member ID card. Your request will be reviewed for medical necessity. If approved, you will be able to continue seeing the current provider for time specified on the approval. You will then be transitioned into Kelsey-Seybold to establish a relationship with a Kelsey-Seybold Physician. If your request is not approved, you will need to begin receiving care from a Kelsey-Seybold physician. The KelseyCare Concierge can help you. Call 713-442-9593.

Do I have access to urgent care clinics?
  • Urgent Care Centers are available through Humana at participating urgent care centers throughout Greater Houston. Urgent care centers treat conditions that need immediate attention, but are not life-threatening, like broken bones, fractures, cuts, lacerations, sprains and strains, fevers, and minor infections.

    In addition, other resources are available including same day/next day primary care appointments and more:

    • The Kelsey-Seybold After-Hours Nurse Hotline at 713-442-0000, available weekdays after 5 p.m., on weekends, and on holidays. A Kelsey-Seybold After-Hours registered nurse will answer your questions, help you access urgent care services when needed, and provide timely professional medical advice. The nurses will also page your physician if necessary, and schedule needed appointments. If a situation appears life threatening, take immediate action and call 911.

    • Saturday Sick-Care Appointments for children and adults are available from 9 a.m. to 2 p.m. at four Kelsey-Seybold locations: Clear Lake Clinic, Tanglewood Clinic near the Galleria, Spring Medical and Diagnostic Center in the FM 1960 area, and Fort Bend Medical and Diagnostic Center in Sugar Land. Call our 24-hour Contact Center at 713-442-0000 after 5 p.m. on Friday or on Saturday morning for a Saturday appointment.


If I am traveling outside of Houston and become ill or suffer an injury, what should I do if I am enrolled in the KelseyCare | Humana plan?

Depending on the severity of your situation, you should: 1) contact your Kelsey-Seybold physician during normal business hours, or 2) contact the Kelsey-Seybold After-Hours Nurse Hotline, available toll free at 1-800-231-6421, 3) seek care from one of the participating urgent care centers available, or 4) go to the nearest emergency room for potential life or limb threatening emergencies. Kelsey-Seybold After-Hours registered nurses have access to your Kelsey-Seybold electronic medical record and can counsel you on appropriate care and next steps. The nurse can page your physician and have medications called into a local pharmacy, as necessary, to treat your condition.

How do I find out which hospitals are in the KelseyCare | Humana plan network?

Kelsey-Seybold physicians use partner hospitals in the Texas Medical Center and surrounding communities. A partial list of our selected facilities used by Kelsey-Seybold physicians includes:

  • CHI St. Luke's Health – Baylor St. Luke's Medical Center, Texas Medical Center, Sugar Land, The Woodlands, and The Vintage.

  • Texas Children's Hospital – Texas Medical Center and Texas Children's – West Campus

  • Houston Methodist – Sugar Land and Houston Methodist – Willowbrook

  • HCA Houston Healthcare Clear Lake

  • HCA Houston Healthcare The Woman's Hospital of Texas

  • Memorial Hermann – Memorial City

  • Memorial Hermann – Katy

  • Kindred Hospital – Medical Center

  • Select Specialty Hospital


What additional services does my KelseyCare | Humana plan offer?
  • Comprehensive medical care delivered by Kelsey-Seybold physicians and affiliated physicians located throughout the Greater Houston area.

  • 24/7 appointment scheduling — Call the Kelsey-Seybold Contact Center at 713-442-0000.

  • KelseyCare Concierge — Call the KelseyCare Concierge, your personal healthcare VIP service, at 713-442-9593 or toll-free at 866-578-7018, Monday – Friday from 8 a.m. to 5 p.m.

  • Access to more than 450 Kelsey-Seybold physicians with no referral needed, plus over 7,200 affiliated physicians and allied health professionals available by referral from your Kelsey-Seybold primary care or specialist physicians.

  • Same-day and next-day In-Person primary care physician appointments and Video Visits (Family Medicine, Internal Medicine, and Pediatrics).

  • On-site laboratories and X-ray.

  • Plus, you'll get around-the-clock services and Saturday appointments for sick care at four Kelsey-Seybold locations:

    • Tanglewood Clinic at 1111 Augusta Dr., Houston, Texas 77057

    • Clear Lake Clinic at 1010 South Ponds Dr., Houston, Texas 77598

    • Spring Medical and Diagnostic Center at 15655 Cypress Woods Medical Dr., Suite 100, Houston, Texas 77014

    • Fort Bend Medical and Diagnostic Center at 1155 University Blvd., Sugar Land, Texas 77478

  • After-Hours Nurse Hotline with Kelsey-Seybold registered nurses. Call 713-442-0000.

  • Email your doctor's office with questions using our secure password-protected service, MyKelseyOnline.

  • Easy prescription refills at pharmacies located at 17 Kelsey-Seybold Clinic locations.

  • Digital diagnostics and high-tech imaging at many locations.

  • No referrals are necessary to see Kelsey-Seybold specialists. Kelsey-Seybold specialists offer expertise in more than 55 medical specialties.

What happens if I am diagnosed with a serious illness or need surgery as a KelseyCare | Humana member?

Your Kelsey-Seybold physicians will deliver and coordinate your care and treatment and engage specialists on your behalf. This may include specialists at other top medical groups and hospitals based on your treatment plan designed to meet your specific care needs. Kelsey-Seybold offers high-quality specialists available in more than 55 specialties, with biographies and physician videos available for viewing at Kelsey-Seybold.com. You can see Kelsey specialists with no referral — just call and schedule an appointment at 713-442-0000. In addition, Kelsey-Seybold has long-term relationships with high-quality affiliate providers, including CHI St. Luke's Health and Texas Heart Institute for cardiovascular surgery, Texas Children's Hospital and Baylor College of Medicine physicians for pediatric specialty care, and many others. Kelsey-Seybold runs the nationally accredited, state-of-the-art Kelsey-Seybold Cancer Center. Please go to Kelsey-Seybold.com/CancerCenter to view the Kelsey-Seybold Cancer Center video and website.

How can I communicate with Kelsey-Seybold online?

MyKelseyOnline is a private and secure way to connect with your Kelsey-Seybold physician. To communicate via the web, sign up at MyKelseyOnline.com or call 713-442-6565 for help with setting up or using your account. With MyKelseyOnline.com, you can:

  • Email your doctor's office

  • Request prescription refills at your Kelsey Pharmacy

  • View most test results, and

  • Make your own appointments with Kelsey-Seybold primary care physicians and an expanding list of specialists, including OB/GYN, Endocrinology, and Rheumatology.

IMPORTANT CONTACTS
ContactServices Number
Kelsey-Seybold Contact CenterAvailable 24 hours a day, 7 days a week to schedule appointments​713-442-0000​
Kelsey-Seybold After-Hours Nurses​Speak with a Kelsey-Seybold nurse after regular business hours, on holidays, and on weekends. 713-442-0000​
KelseyCare Concierge Service​Assistance with appointment scheduling and information about participating physicians, clinic locations, and services available at each clinic713-442-9593 or
1-866-578-7018 ​
MyKelseyOnline (MKO)Help with setting up or using your MyKelseyOnline account​​713-442-6565


Why should I, as an employer, offer the KelseyCare | Humana plan?

Because the KelseyCare plan has a proven track record of delivering a total lower medical cost compared to competing plans, while delivering improved quality, greater engagement in preventive care, and improved member satisfaction. KelseyCare is the proven, affordable option. Check out these case studies and testimonials by our employer partners. Our plan can be offered as a choice alongside PPO, POS, and other plans. You can be confident in our track record on enrollee satisfaction. Check out these member testimonials and the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, where members express their satisfaction level with their plan.

What are my employees going to receive from the KelseyCare plan that's different from what they get today from Kelsey-Seybold?

You still get the same great quality, conveniences and access to care you've always known from Kelsey-Seybold, plus a whole lot more:

  • Greater Value: lower premiums and lower total medical cost

  • Comprehensive care coordination by Kelsey-Seybold physicians

  • Integrated disease management and case management

  • Exclusive KelseyCare Concierge available at 713-442-9593

  • Access to Kelsey-Seybold's partner hospitals, including:

    • CHI St. Luke's Health – Baylor St. Luke's Medical Center, Texas Medical Center, Sugar Land, and The Woodlands

    • Texas Children's Hospital – Texas Medical Center and Texas Children's – West Campus

    • Houston Methodist – Sugar Land and Houston Methodist – Willowbrook

    • HCA Houston Healthcare Clear Lake

    • HCA Houston Healthcare The Woman's Hospital of Texas

    • Memorial Hermann – Memorial City

    • Memorial Hermann – Katy

Do I have to give up my existing plans to offer this?

No. You can offer the KelseyCare plan alongside your other plan options for greater access and choice for your employees.

We are happy to offer references upon request.


Employer Testimonials

Testimonials posted on this site are examples of the results and experiences of some of our clients. No compensation was provided for these testimonials.


  • Amy Milstead, Milstead Automotive President

    Health Plans for Companies with Two or More Employees

    "With KelseyCare, we've lowered our healthcare costs and improved the health of our employees."


    – Amy Milstead, President, Milstead Automotive


    "Milstead Automotive has offered the KelseyCare plan to its employees since 2014. We've reduced our total medical costs, and we're keeping our employees healthier and out of the hospital. Kelsey-Seybold wellness staff visit us on-site four times a year, teaching healthy living classes, administering flu shots and helping our employees schedule their preventive checkups with their doctors."


  • Omar Reid, Former City of Houston HR Director

    City of Houston Saves $42 Million in Healthcare Costs by Implementing New Benefits Strategy


White Papers

The Proven Solution is Here

CAHPS has rated KelseyCare among the best in three overall categories

How Disruptive Innovation Can Revolutionize Healthcare


News Stories

A smaller network, but better health?
Houston Chronicle, March 26, 2017

Ounce of Prevention
Houston Chronicle, May 24, 2015

Trying Out New Ways to Deliver Health Care
The New York Times, October 7, 2011

Trying to Limit Outside Influence in Prescribing Drugs
The New York Times, June 14, 2014


Disclaimer:
Humana Inc. and its subsidiaries comply with all applicable federal civil rights laws and do not discriminate or exclude people on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, or disability. We also provide free language interpreter services. See our full accessibility rights information and language options.

Telemedicine
Limitations on telehealth services, also referred to as virtual visits or telemedicine, vary by state. These services are not a substitute for emergency care and are not intended to replace your primary care provider or other providers in your network. Any descriptions of when to use telehealth services are for informational purposes only and should not be construed as medical advice. Please refer to your evidence of coverage for additional details on what your plan may cover or other rules that may apply.