Humana Medicare Advantage plans are an alternative to Original Medicare, which includes Part A, covering hospitalization, and Part B, covering doctor visits.
The Advantage plans provide the benefits of Original Medicare and often also include prescription drug coverage and supplemental benefits, such as dental and vision care.
Humana, a private insurance company, offers six types of Advantage plans. The options vary in terms of costs, coverage, and rules regarding choosing a doctor.
Below, we discuss the types of plans, cost components, and payment waivers. Then, we look at how to enroll.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Humana was founded in 1961, and its headquarters are in Louisville, Kentucky.
The company offers healthcare coverage for Medicare beneficiaries and individuals who do not have Medicare. More than 8.4 million people are enrolled in its policies.
Humana Medicare health policies include:
- Advantage plans
- Part D plans, which include prescription drug coverage
- Medigap plans, which are Medicare supplement plans
Humana Medicare Advantage plans have more than 4 million enrollees. Options include:
- health maintenance organization (HMO) plans
- preferred provider organization (PPO) plans
- private fee-for-service (PFFS) plans
- special needs (SN) plans
The company also introduced two new plans in 2020.
The coverage that Advantage plans provide includes the Part A and Part B benefits of Original Medicare. The plans may also provide coverage of prescription drugs.
Other additional benefits may include fitness programs and vision and dental care. Some plans cover emergency healthcare when traveling in a foreign country.
HMO plans require a person to select their primary care doctor from in-network providers. This doctor coordinates all of their care.
If an individual wants to change their doctor, they may do so as long as they pick from those within the network.
If a person needs a specialist, the primary care doctor can refer them to one who is also within the network. HMO plans typically have lower premiums and out-of-pocket costs than other plans.
PPO plans allow an individual to choose any Medicare-approved doctor, even if they are not within the network of providers. However, costs are usually lower if a person picks an in-network doctor.
An individual with a PPO plan does not need a referral to see a specialist.
PFFS plans determine the amount that healthcare providers receive and the amount that enrollees have to pay.
An individual may see almost any Medicare-approved doctor. The only regulation is that a person’s doctor must consent to Humana’s payment terms and conditions.
The terms involve agreeing to provide services that the plan considers medically necessary, as well as accepting the payments that Original Medicare has set.
SN plans tailor benefits to specific groups’ health needs. Humana offers two types: dual eligibility SN plans and chronic condition SN plans.
Dual eligibility SN plans are available to people who are eligible for both Medicare and Medicaid.
Chronic condition SN plans are available to anyone with at least one of the conditions below:
The two types of SN plans are not available throughout the country. Humana offers dual eligibility SN plans in 25 states and chronic condition SN plans in 10 states.
Humana now offers an HMO-POS plan. It is similar to a traditional HMO plan, but it gives a person the option, under certain circumstances, of using out-of-network providers.
The company also has a new Advantage plan, called Humana Honor. It will complement the healthcare available for military veterans, although anyone who qualifies for Medicare is eligible.
Humana Honor comprises 17 plans and is available in 28 states.
The costs associated with the Advantage plans vary, and they involve several components.
Each plan fixes the amounts for premiums, deductibles, and services, as well as how much a person pays for services. According to the Kaiser Family Foundation, monthly premiums vary between $0 and $100 or more.
Copayments and deductibles also differ. The plans put a yearly cap on healthcare costs.
A person with an Advantage plan must also pay the Medicare Part B premium, although some plans may pay part of it.
During the 2020 COVID-19 outbreak, many people are forgoing preventive and primary health services.
To reduce some obstacles in getting essential healthcare, Humana is waiving in-network primary care costs. These include expenses relating to COVID-19, along with all primary care doctor visits for the year.
Humana is extending telehealth waivers for cost sharing. This waiver includes visits with primary care doctors, specialists, and behavioral health practitioners, as long as they are in-network providers.
A person may enroll in one of the Medicare Humana Advantage plans during the Initial Enrollment Period. This 7-month window includes the 3 months either side of the month in which an individual turns 65.
If someone misses enrolling during this time, they may sign up during the annual open enrollment period from October 15 to December 7.
A person can find the Humana Advantage plans available in their area and compare costs using this tool. Once they have selected the plan that suits their needs, they may enroll by calling Humana on 1-888-204-4062.
As companies other than Humana offer Advantage plans, and prices vary among companies, it is a good idea to compare prices before buying. This tool shows the options from all of the companies serving a person’s area.
Humana Medicare Advantage plans provide the basic coverage of Original Medicare, but they often include additional benefits. A person may choose from four plans that differ in various ways. Humana also launched two new plans.
The costs may include monthly premiums, copayments, and deductibles. Each plan puts a yearly cap on costs, so an individual does not have to pay healthcare expenses exceeding this amount.
If someone is interested in getting an Advantage plan, they may consider the Humana plans while also checking out Advantage plans from other health insurance companies.