November 03, 2017
Available from Medicare-approved insurance companies like Humana, Medicare Advantage plans are required to provide at least the same level of coverage as Original Medicare Part A (hospital insurance) and Part B (medical insurance). The exception is hospice care, which remains covered by Medicare Part A. Many Medicare Advantage plans, including those available from Humana, may offer additional benefits such as routine vision and hearing services, routine dental care, gym memberships, and/or prescription drug coverage.
What are Medicare Advantage plan provider networks?
Medicare Advantages plans, including Humana, often contract with Medicare-assigned health-care providers to deliver medical services to plan members. This provider network might include hospitals, skilled nursing facilities, clinics, ambulatory surgical centers, durable medical equipment suppliers, laboratories, primary care doctors and specialists, and other health professionals. Some Medicare Advantage plans may also include contracted pharmacies.
When do I need to use Humana’s network of participating providers?
Humana offers several types of Medicare Advantage plans that may use contracted health-care providers to provide covered medical care to plan members. You may already be familiar with two of these popular plan types: Medicare Advantage Health Maintenance Organizations (HMO) and Medicare Advantage Preferred Provider Organizations (PPOs).*
If you enroll in a Medicare Advantage HMO offered by Humana, generally you must receive your care from health-care providers participating in the plan’s network to receive the benefits of the plan. There may be some exceptions to this rule—for example, emergency care or urgently needed care (such as medically necessary dialysis treatment) while traveling outside the Medicare Advantage plan’s service area. You may need to choose a primary care physician in the plan’s network to serve as your personal doctor and coordinate your medical care, including referrals to specialists when you need it.
However, if you enroll in a Medicare Advantage PPO offered by Humana, you typically have more flexibility in deciding whether to use health-care providers participating in the plan’s network or outside the network. Most Medicare Advantage PPO plans do not require that you have a primary care physician, and you may be able to see specialists without a referral.
In a PPO plan, in general your cost savings may be greater when you see in-network providers. In most cases, network providers will not charge members for more than the contracted amount for covered services (you may be subject to any applicable plan deductibles).
How do I find Humana network providers for my Humana Medicare Advantage plan?
Humana makes it convenient for you to find health-care providers who participate in their Medicare Advantage plans. Humana’s online provider search tool lets you search by your Humana ID number if you are already a plan member, or by the Medicare Advantage plan name. You can filter the results by typing in the provider’s name, provider type, specialty, or even on a health condition. You can narrow or broaden your search by entering the distance in miles from your home zip code.
If you use a tablet or smartphone, you can download the free MyHumana mobile app and use the built-in search tool included in the app. Standard data rates may apply. The mobile app also includes features to help you manage your Humana plan benefits, such as viewing claims, ordering ID cards, and reviewing your plan coverage and benefits.
Are you interested in enrolling in a Medicare Advantage plan from Humana? If so, remember that you need to be enrolled in Medicare Part A and Part B, and continue paying your Part B premium, as well as any premium the plan may charge. To learn more about the Medicare Advantage plans Humana offers and their network providers, you may use the Find Plans button on this page. If you would like personal assistance, you can speak with one of eHealth’s licensed insurance agents at 1- 888-323-1149 (TTY users dial 711) Monday through Friday, 8AM to 8PM ET.
Humana is a Medicare Advantage HMO, PPO, and PFFS organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any Humana Medicare plan depends on contract renewal.
This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums and/or member cost-share may change on January 1 of each year.
You must continue to pay your Medicare Part B premium.
The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.
Last Updated: 11/3/2017