Last Updated on
November 03, 2017
Humana offers a variety of Medicare Advantage plans throughout most of the United States. Some of them may have optional supplemental benefits that you can add to your coverage. You may want to take a closer look at Medicare Advantage plans from Humana as you consider your Medicare coverage options.
How do Medicare Advantage plans from Humana work?
Medicare Advantage plans offer a different way for you to receive your Original Medicare Part A and Part B benefits, and some plans may include additional benefits. Instead of receiving your coverage directly from the government-sponsored Medicare program, you receive your benefits through a Medicare Advantage plan, also referred to as Part C. These plans are offered by private insurance companies– such as Humana– that contract with Medicare.
If you enroll in a Medicare Advantage plan, you receive at least the same benefits you would have under Original Medicare Part A (hospital insurance) and Part B (medical insurance), with one exception: hospice care remains covered under Medicare Part A. Humana offers Medicare Advantage plans that usually include prescription drug coverage. Some of Humana’s Medicare Advantage plans include prescription drug coverage at no additional cost, while the other plans offer this coverage for an additional monthly premium. You may be able to add on optional supplemental benefits to your Medicare Advantage plan from Humana that Original Medicare does not offer, such as routine dental or vision care – again, an additional premium may apply. However, some Humana Medicare Advantage plans include coverage for routine dental and vision services.
Costs and availability of Humana’s Medicare Advantage plans may vary, along with specific details of benefits beyond Medicare Part A and Part B. If you enroll in a Medicare Advantage plan, you’re still in the Medicare program, and you will continue paying your monthly Medicare Part B premium, plus any additional monthly premium your plan may require. Copayments, coinsurance amounts, deductibles, and premiums may vary by plan type and location.
What additional benefits may be available with Medicare Advantage plans available from Humana?
Depending on the specific Humana plan you sign up for, your Medicare Advantage plan might include prescription drug coverage (sometimes at an additional monthly premium).
If you decide to enroll in a Medicare Advantage plan offered by Humana, you may have the opportunity to add optional supplemental benefits like routine vision, hearing, or dental services, and/or fitness benefits.
What types of Medicare Advantage plans does Humana offer?
Humana offers a variety of types of Medicare Advantage plans, although not every type of plan may be available where you live. Here’s a quick look at Medicare Advantage plans available from Humana:
- Health Maintenance Organization (HMO): Humana Gold Plus®, a Medicare Advantage HMO plan, may require you to visit doctors, health-care providers, and hospitals in the plan’s network, except in emergency situations or when approved by the plan. You select a primary care physician from the plan’s network who coordinates your care, including referrals to specialists who typically also participate in the network. Your out-of-pocket costs may be lower in a Medicare Advantage HMO plan than in other types of Medicare Advantage plans.
- Preferred Provider Organization (PPO)*: HumanaChoice® PPO plan offers flexibility, letting you choose doctors and hospitals outside of your plan’s network, but usually at a higher out-of-pocket cost for covered services than you would pay if you used a provider in Humana’s network. You may see specialists without a referral, and the plan will pay for covered services.
- Private Fee-for-Service (PFFS): A Medicare Advantage PFFS plan such as Humana Gold Choice ® may give you the flexibility to see any Medicare-assigned doctor who accepts Humana’s terms of payment. Keep in mind that not all providers accept this type of plan. You may want to verify with Humana or the provider that he or she will accept Medicare assignment and the plan’s terms before receiving services if you decide to enroll in a Medicare Advantage PFFS plan.
- Medicare Special Needs Plan (SNP): Humana offers some Medicare Advantage Special Needs Plans designed to help Medicare beneficiaries who have particular needs, such as dual eligibility for Medicare and Medicaid benefits or residence in long-term skilled nursing facilities. Some Special Needs Plans from Humana may be available for individuals who have certain health conditions, such as (but not limited to) end-stage renal disease, chronic lung disease, or congestive heart failure.
To learn more about Medicare Advantage plans available where you live, enter your zip code in the Plan Finder located on this page. If you prefer, you can call eHealth licensed insurance agents at 1- 888-323-1149 (TTY users can call 711) Monday through Friday, 8AM to 8PM ET.
*Out-of-network/non-contracted providers are under no obligation to treat Humana members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
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 plan depends on contract renewal. For Dual-Eligible Special Needs plans, Humana is a Coordinated Care HMO plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in any Humana plan depends on contract renewal. These plans are available to anyone who has medical assistance from both the State and Medicare. Premiums, copays, coinsurance, and deductibles may vary based on the level of extra help you receive. Please contact the plan for more details.
Dual-Eligible Special Needs plans offered in Florida are sponsored by Humana Medical Plan, Inc. and the State of Florida, Agency for Health Care Administration.
You must continue to pay your Medicare Part B premium.
A plan’s formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.
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.
This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
Humana MyOption optional supplemental benefits (OSB) are only available to members of certain Humana Medicare Advantage (MA) plans. Members of Humana plans that offer OSBs may enroll in OSBs throughout the year. Benefits may change on January 1st each year.
Enrollees must continue to pay the Medicare Part B premium, their Humana plan premium, and the OSB premium.
Last Updated: 11/3/2017