Humana is a respectable health insurance company that provides a large selection of Medicare Advantage plans to meet the requirements and finances of senior citizens across the country. It resides in Louisville, Kentucky, and was founded in 1961. Additionally, it ranks as the fifth-biggest health insurance supplier in the US.
It serves almost 9 million Medicare beneficiaries, over 5 million who are enrolled in Medicare Advantage plans. It covers hospitalization and doctor visits under Part A and Part B, which is an alternative to Original Medicare. While the majority of Humana’s Medicare enrollees are in highly rated contracts, some have lower rankings, so it’s wise to shop around before committing.
How Humana Medicare Advantage Plans Works
The Humana Medicare Advantage plans offer a unique group of pharmacists, specialists, and providers. These plans include private fee-for-service (PFFS), special needs (SNP), preferred provider organization (PPO), and health management organization (HMO).
Health management organization (HMO)
The cost-effectiveness of Health Maintenance Organization (HMO) plans makes them appealing to a large number of individuals. These plans have a $0 monthly premium which is available in many ZIP areas. Moreover, you must select your physicians, including your primary care physician (PCP), from the plan’s provider network, just like you would with any other HMO.
With Humana’s Point-of-Service (HMO-POS) plan, you can select out-of-network providers under specific conditions. In addition, emergency medical care received outside of the US is covered by Humana’s HMOs.
Prescription drug coverage that is superior to Medicare Part D plans is another feature offered by certain Humana HMOs. The majority of these programs give free access to numerous neighborhood fitness centers and gyms. Not all fitness centers are listed here.
Preferred provider organization (PPO)
Plans known as PPOs (Preferred Provider Organizations) allow you to see any physician who is approved by Medicare. However, out-of-plan providers will typically incur higher costs. Also, a recommendation is not required to see a specialist.
Under these plans, in-network home health care is offered. In addition, they provide elective extras like dental, vision, prescription medicine, and exercise plans. Another benefit is emergency care received outside of the United States.
Special needs (SNP)
Special Needs Plans (SNPs) are offered at no cost which does not impose copays, premiums, or coinsurance. SNPs are only accessible if you fulfill particular requirements, like:
- Living in particular inpatient settings, like a nursing home
- Having a chronic illness that is deemed incapacitating enough by Medicare to qualify for snp
- Eligibility for both Medicaid and Medicare
Moreover, there are two varieties of SNPs offered by Humana, and they are accessible in about 20 states. Those who are eligible for both Medicare and Medicaid fall under one category. In addition, the second category is for people with specific long-term medical issues, like:
- Heart conditions
- Persistent cardiac conditions
- Persistent lung conditions
- End-stage renal disease with diabetes
You will receive Medicare Part D in addition to all original Medicare benefits if you are eligible for a Humana SNP. Programs for health and well-being may also be offered for preventive care and illnesses like diabetes. Furthermore, SNP offers coverage for dental, vision, and hearing care, as well as non-emergency medical transportation services.
Private fee-for-service (PFFS)
Not every location offers private fee-for-service (PFFS) options. Any Medicare-approved physician may be seen with a PFFS plan, provided that the physician has agreed to Humana’s PFFS terms of service and payment guidelines. Medicare supplement plans and Humana PFFS plans are not the same.
Humana will decide how much it pays hospitals and medical professionals as well as how much you must pay for your care because they are the insurer and not Medicare. You can choose any primary care physician to work with under a PFFS plan. To see a specialist, you won’t need a reference.
What States Offer Humana Medicare Advantage Plans
In 49 states, Humana provides Medicare Advantage plans. In Alaska, Medicare Advantage plans are not offered at this time. Despite being widely available across the nation, some plans and coverage options could only be available in a few locations.
This implies that you might not be able to purchase the same Humana plan if your relative lives in a different state.
How Much Does Humana Medicare Advantage Plans Cost
The Advantage plans come with a variety of expenses that are divided into multiple categories. The premiums, deductibles, and service quantities, as well as the cost of individual services, are all fixed numbers for each plan. Moreover, the Kaiser Family Foundation states that monthly rates range from $0 to $100 or more.
However, deductibles and copayments are also different. The health care costs are capped annually under the programs. The Medicare Part B premium is not covered by an Advantage plan
What Does Humana Medicare Advantage Plans Cover
Every Humana Medicare Advantage plan type includes a different set of supplemental services on top of what Medicare provides by default. Some of the coverage advantages that many Humana plans provide are as follows:
- Vision
- Dentistry
- Home health care
- Gym memberships, or exercise regimens
If you need flexibility, Humana Medicare Advantage Plan offers the best option. The organization provides a wide range of programs that are accessible all around the nation. This includes a Medicare supplement with a high deductible (Plan G), which is not easily obtained from other insurers.
