Understanding Humana Medicare Advantage: Key Facts to Consider

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Humana Medicare Advantage offers recipients a plan with new features. There are changes in how much patients pay before insurance kicks in for medical expenses incurred when they visit their doctor’s office.

Humana Medicare Advantage Offers Recipients a Plan with New Features

There are changes in how much patients pay before insurance kicks in for medical expenses incurred when they visit their doctor’s office.

Medicare is always a good idea to have. When you are healthy, the risks of running into an illness seem remote and easily manageable. But when it happens, there will be expenses that could potentially drain your savings or be expensive if not covered by a healthcare plan.

It’s really easy to become overwhelmed when it comes to health insurance. The good news is that this article can assist you in understanding what Humana Medicare Plan offers!

What is the Humana Medicare Plan?

Humana is a for-profit health insurance company in Kentucky approved by Medicare to offer Part C plans. It’s also the country’s second-largest Medicare Advantage plan provider.

In all 50 states, Humana Medicare plans are accessible. Quality and customer satisfaction are essential aspects of their programs, and they provide a vast array of additional advantages.

The majority of its Medicare clients are registered in high-quality plans with a four-star rating. And these medical plans come with some pleasant bonuses.

Humana plans were chosen by 18 percent of Medicare Advantage members. Are Humana’s plans, however, suitable for you?

In addition, Humana Medicare customers have access to some of the best-rated plans. But, unfortunately, not all Humana contracts offer you a choice between different plan options. So it’s important that before signing up with them, you do your research and find out what will be best!

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Humana Medicare Advantage Plan

Humana provides various Medicare Advantage plans, each with its system, pricing, and benefits. And through SilverSneakers, dental, fitness, and vision benefits are also offered. Besides, it provides Medicare Advantage Prescription Drug Plan and stand-alone Prescription Drug Plans. They also offer Medicare Advantage Plans without drug coverage.

Likewise, Humana Honor, the company’s Medicare Advantage plan intended for U.S. military veterans, expanded into 46 states.

The following forms of plans are available as well:

Health Maintenance Organization (HMO) Plans

Many consumers are drawn to Health Maintenance Organization (HMO) plans due to their low cost. There are plans available for a $0 monthly fee in many ZIP codes.

HBO plans are required by law to account for nearly as much as original Medicare. You can count on medical treatment and preventative care, such as yearly screenings and immunizations.

The regulations and benefits below are taken into account with the HMO Plan:

  • You must select your doctors from the plan’s service provider, including your primary care physician (PCP).
  • (In some instances) Humana offers a Point-of-Service (HMO-POS) plan that allows you to pick out-of-network providers. To see specialists and other doctors, you’ll need referrals from your primary care physician.
  • Outside of the United States, Humana’s HMOs include emergency medical treatment.
  • In some cases, Humana’s HMOs provide prescription medication coverage comparable to or better than stand-alone Medicare Part D plans.
  • The majority of these programs offer complimentary gym and health club memberships in the area. The list, however, does not contain every fitness center.

Preferred Provider Organization (PPO) Plans

Preferred Provider Organization (PPO) plans allow you to see any Medicare-approved doctor of your choice. Out-of-plan providers, on the other hand, would always be more expensive.

The regulations and benefits below are taken into account with the PPO Plan:

  • See a specialist without being referred by another doctor.
  • In-network home health care is available through these plans. Optional add-ons include vision, dental, and prescription medication coverage, as well as exercise programs.
  • Emergency care is outside of the United States.

Private Fee For Service (PFFS) Plans

PFFS plans aren’t accessible everywhere. You can see any Medicare-approved doctor with a PFFS plan, as long as they accept Humana’s PFFS terms of service and payment conditions.

The regulations and benefits below are taken into account with the PFFS Plan:

  • No need for primary care physician designation if you have a PFFS plan.
  • The majority of yearly preventative check-ups are free of charge.
  • Prescription medication coverage is available in most PFFS plans, but not all.
  • Outside of the United States, emergency care is covered.

Special Needs Plans (SNP)

SNPs (Special Needs Plans) are usually free, with no premiums and deductibles or copay. Yet, SNPs are only available if certain conditions are met, such as:

  • Living in a nursing home or other sorts of healthcare settings.
  • Having a chronic illness Medicare authorizes Medicare and Medicaid SNP eligibility.

The other category is for those who have specific chronic illnesses, such as:

  • Coronary heart disease
  • Chronic heart illness
  • Chronic obstructive pulmonary disease (COPD)
  • End-stage renal disease in people with diabetes (ESRD)

You’ll get all of the advantages of traditional Medicare plus Medicare Part D if you qualify for a Humana SNP and other benefits such as:

  • Preventative treatment for illnesses such as diabetes and health and wellness programs may be incorporated.
  • Routine dental, eye, and hearing treatment, and non-emergency medical transportation are covered.
  • A predetermined amount of over-the-counter (OTC) authorization is generally included.

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Humana Medicare Plan Additional Benefits

Medicare Advantage plans provide additional benefits, including hearing aids and over-the-counter medicines. Some even offer food coverage!

Other wellness initiatives offered by Humana to Medicare beneficiaries include:

  • Humana Well Dine: You can get a set amount of meals delivered to your home if you’re recovering from a nursing facility or if you’re enrolled in an SNP plan.
  • Insulin Savings Program: This benefit helps members pay less for diabetic medicines.
  • Healthy Foods Card: All members of Special Needs Plans are eligible for a Healthy Foods Card. It allows them to spend up to $75 per month on approved healthy foods and drinks.
  • Allowance: Some plan members may be given a budget to spend on over-the-counter products.
  • COVID-19 Benefits: Humana offers $0 high deductibles for COVID-19 testing as well as a $0 copay for medication. They also have 14 days of home-delivered meals for members with a COVID-19 diagnosis.
  • Telehealth: Telehealth copays for appointments with a primary care doctor and emergency treatment. Outpatient mental health is waived for all Medicare Advantage participants.

Advantages and Disadvantages of Humana Medicare Plan

Despite its popularity, Humana’s Medicare Plan offers both drawbacks and benefits.

Advantages

  • Widely Accessible: Humana is the most widely available provider, with plans available in 2,703 counties (or 84 percent) across the United States.
  • COVID-19 Benefits: Humana offers $0 high deductibles for COVID-19 testing as well as a $0 copay for medication. They also have 14 days of home-delivered meals for members with a COVID-19 diagnosis.
  • Quality Coverages and Plans: Many Humana Medicare Advantage plans include dental, eye, and hearing care, which Original Medicare does not cover.

Disadvantages

  • Special Needs Plan Accessibility: Special Needs plans aren’t accessible everywhere. Humana’s Chronic Condition SNPs are only available in 12 states.
  • Customer Satisfaction Level: Some Humana plans do not receive high marks for consumer satisfaction.

Humana Medicare Plan Cost

The cost of a Medicare Advantage plan varies depending on the program, your area, and your healthcare needs. The plan’s premium is one of the expenditures to consider. Good thing that Humana has recently extended its selection of $0-premium plans.

As a member, you will still be responsible for paying your Medicare Part B payment. Its cost will be at least $148.50 in 2024 if you’re on Medicare Advantage.

Other out-of-pocket expenses to think about are:

  • Whether the plan covers Medicare Part B premium.
  • The annual deductibles and additional deductibles, such as medication deductibles.
  • Copayment and coinsurance on treatment/doctor visits.
  • The plan’s out-of-pocket maximum.
  • Your choice of extra benefit.

Remember that the cost of these plans differs depending on the area, method, and location. For accurate rates, you may visit Humana’s website and compare the various programs.

Humana Medicare Plan Competition

The UnitedHealthcare Plan is one of Humana’s main competitors. Both are Medicare Advantage plans with a broad client base. 

Humana is available in 84 percent of counties, 66 percent have UnitedHealthcare, and 60 percent have both. More so, UnitedHealthcare is the nation’s largest health insurer, with a market share of 14 percent.

UnitedHealthcare also has an exclusive agreement with AARP, giving them a distinct edge as a well-known brand. 

The average Star Ratings for UnitedHealthcare are somewhat higher. In addition, both firms provide online tools or applications as well as numerous customer service methods.

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Final Thoughts

Before choosing a healthcare program for yourself, it’s critical to do your research. Humana, for example, has the widest choice of Medicare plans of any insurer in the country.

Humana is not only one of the most popular Medicare plans, but it is also one of the best-rated overall. They also provide a variety of methods to join the program and participate in it. 

Most importantly, along with health and wellness initiatives, Humana offers a variety of additional advantages. 

So if you are planning to provide yourself with a healthcare program, make sure to check Humana Medicare Advantage Plan!

Did you enjoy reading the article above? If so, we would love to hear what you want to cover next. Leave a comment below with any feedback or stories from when you needed this plan!

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