Humana Medicare Advantage Plans Review

Available Humana Medicare Advantage Plans

Humana Medicare Advantage Plans are an alternative to Original Medicare (Part A and Part B). Humana’s plans cover Part A and and Part B along with other benefits, such as prescription drug coverage and routine vision, hearing, and dental care.

Humana offers four different types of Medicare Advantage plans, but your specific number of plan options will vary based on your location. To help you out, the Humana website will compile a list of recommended plans based on questions you answer about your current prescriptions, current doctors, and your veteran status. Then, you can directly compare the options that you’re interested in.

Below, we’ll take a look at the different types of plans offered through Humana. Just know that benefits and plan availability may change based on your location.

HMO Plans

Humana’s health maintenance organization (HMO) plans offer medical and prescription drug coverage. With an HMO plan, you need to select a primary care physician (PCP) from a local provider network, whom you can see as often as you need. You can change your selection at any time, but you’ll still need to choose from a list of in-network PCPs. Humana’s HMO plans also require referrals for specialists, so this plan might be a hassle for seniors who regularly see specialists.

Other benefits of Humana HMO plans include routine dental, vision, and hearing care, the SilverSneakers fitness program, and an OTC drugs and supplies allowance. Some plans come with a Healthy Foods Card or meal delivery service, while others include an insulin savings program, which is worth looking into if you have diabetes.

Humana’s HMO plans are best for older adults and other beneficiaries who:

• Want to spend as little money as possible
• Don’t typically see specialists
• Have doctors that participate in-network with Humana

PPO Plans

If you want more choice in what doctors you see, consider a preferred provider organization (PPO) plan from Humana. With this plan type, you can visit any Medicare-approved doctor, even if they’re out of Humana’s provider network. However, you will typically pay more if you choose an out-of-network provider. Generally, Humana’s PPO plans cost more than HMO plans, but you get the benefit of greater flexibility in choosing your doctors. Plus, you don’t need referrals for any services.

Along with Original Medicare benefits, PPO plans may include the same extra benefits you can get with HMO plans.

Humana’s PPO plans are best for older adults and other beneficiaries who:

• Want more flexibility in choosing care providers
• See specialists and don’t want to deal with referrals
• Don’t mind paying a little more in premiums

PFFS Plans

Humana’s private fee-for-service (PFFS) plan type lets you see most Medicare-approved doctors. The only catch is that the doctor must accept the Humana PFFS terms and conditions of payment. Humana decides how much the plan will pay for services and how much you will pay. PFFS plan benefits might include prescription drug coverage, full coverage for annual preventive screenings, hospitalization coverage, and emergency coverage domestically and internationally.

Many Humana PFFS plans also come with an OTC allowance for over-the-counter medications or first-aid supplies and a SilverSneakers fitness program membership.

Humana’s PPO plans are best for older adults and other beneficiaries who:

• Don’t want to choose a PCP
• Want more flexibility regarding which providers they can see
• See specialists and don’t want to deal with referrals
• Don’t mind paying higher out-of-pocket costs for out-of-network healthcare services

Humana Special Needs Plans

Humana also offers special needs plans (SNPs) for people who have specific conditions. An SNP plan can also be an HMO or a PPO. However, SNPs must always include Original Medicare benefits plus prescription drug coverage. Other benefits may include routine dental, vision, and hearing care, an OTC allowance, a SilverSneakers membership, and a Healthy Foods Card.

Humana’s Chronic Condition SNPs cater to Medicare beneficiaries with diabetes mellitus, cardiovascular disorders, chronic heart failure, and/or chronic lung disorders. The company’s Dual-Eligible SNP is for individuals who are eligible for Medicare and Medicaid. It combines your Medicare and Medicaid benefits in one plan that’s easy to manage.

Humana’s SNP plans are best for (and only for) older adults and other beneficiaries who:

• Have a qualifying chronic health condition
• Are eligible for Medicare and Medicaid
• Live in one of the 28 states that Humana SNPs are offered in2

Extra Perks and Benefits

Some Humana Medicare Advantage plans come with additional perks and benefits. Availability will vary based on your plan type and your location.

• SilverSneakers membership: A fitness membership that grants you access to live online fitness classes, participating gym and fitness center locations, and in-person exercise classes designed for seniors.
• Insulin Savings Program: Members pay just $35 or less at all in-network pharmacies for a 30-day supply of insulin. Some plans have $0 insulin copays.
• OTC allowance: Some plans include an allowance that you can use for vitamins, pain relievers, cold medicines, first-aid supplies, and other OTC medications and supplies.
• Healthy Foods Card: Receive $25 to $50 each month to shop for approved healthy foods at participating stores. The balance doesn’t roll over from month to month.
• Well Dine meal delivery program:Following an inpatient stay in the hospital or a skilled nursing facility, members may receive a set number of free meals delivered to their homes. Seniors with Humana SNPs can also receive 20 meals per eligible condition each year.
• Wigs: Select plans include up to a $500 maximum benefit per year to cover the cost of a wig (only related to chemotherapy treatment).
• Transportation: Get a $0 copay for up to 24 one-way trips per year. Locations must be plan approved, and you must contact Humana’s transportation vendor to arrange your ride.

How Much Do Humana Medicare Advantage Plans Cost?

Plan prices vary greatly from person to person, plan to plan, and location to location. Fortunately, Humana makes it simple to see how much you might owe. Simply visit their website to get started.

Premiums for Humana’s plans start at $0 per month in addition to your Medicare Part B premium. In 2023, the standard part B premium amount is $164.90, but this number can go all the way up to $560.50 per month for high-earning seniors3.

Other expenses you may want to compare as you evaluate plans are copays and maximum out-of-pocket expenses.

Based on a Pennsylvania ZIP code, Humana’s plans range from $0 to $20 per PCP visit and $0 to $50 per specialist visit. Again, these numbers will vary depending on where you live and the plan you choose. Some plans cap their out-of-pocket expenses, while others have no maximum out-of-pocket responsibility. For example, one plan had a maximum of $2,600, while another’s was $6,700.

Where Are Humana Medicare Advantage Plans Available?

Humana has more than 5 million Medicare Advantage customers. Its plans are available in all 50 states and Washington, D.C., but plan availability changes based on the county you live in.

From 2021 to 2022, Humana expanded the number of counties it serves by 294. Humana’s Medicare Advantage plans are currently available in 85 percent of counties, meaning it serves more counties than any other Medicare Advantage carrier. Nearly 9 out of 10 Medicare beneficiaries have access to at least a single Humana Medicare Advantage plan. Older adults and other Medicare beneficiaries in some counties have as many as 14 plan options to choose from.

To see which plans are available in your area, visit plans.humana.com, type in your ZIP code, and select your county.

Reviews and Ratings

Several third parties rate Medicare Advantage plans. Take a look at how Humana did:

• Centers for Medicare and Medicaid Services (CMS): Ninety-seven percent of Humana Medicare Advantage customers are in contracts with a 4-star rating or higher (out of 5)5. CMS found that four contracts have 5-star ratings, eight contracts have 4.5-star ratings, and 20 have 4-star ratings.
• AM Best: Humana received an “A” (Excellent) rating from AM Best, which indicates that it can meet its financial obligations.
• Better Business Bureau (BBB): Humana has been accredited with the BBB since 1998 and currently has an A+ rating6. There have been 197 customer complaints closed in the past three years.
• National Committee for Quality Assurance (NCQA): Humana has many NCQA-accredited entities7. Ratings for Humana’s Medicare products range from 2.5 to 4 stars out of 5.
• J.D. Power: Humana ranked fourth overall in the 2021 U.S. Medicare Advantage Study Overall Customer Satisfaction Index Rating8.

Each agency takes different factors into consideration when evaluating Humana, including customer satisfaction, diversity of product offerings, and financial health. The most relevant ratings to consider are from CMS and J.D. Power, as both parties evaluated Humana’s Medicare-related products only.

Customer Service

You can reach Humana’s customer service team online, over the phone, or by mail. Call Humana’s Medicare customer service team at (800) 457-4708 (TTY: 711) from 8 a.m. to 8 p.m., Monday through Friday. To chat online with customer service, you’ll need a Humana account. Online chat support availability varies depending on hours of operation and representative availability. If you have simple questions, you can reach out to @HumanaHelp on Twitter from 6 a.m. to 8 p.m., seven days a week. You can also also send mail to Humana Inc., 500 W. Main St.
Louisville, KY 40202.

Final Thoughts on Humana Medicare Advantage Plans

Humana’s Medicare Advantage plans are more widely available than those from other private insurers. This company offers four different plan types with varying premiums, copays, and out-of-pocket maximums so that you can easily find a plan that fits your budget and medical needs. Plus, many of the plans include prescription drug coverage, routine hearing, dental, and vision care, fitness benefits, and more. And, since their website is so user-friendly and lets you compare plans based on your ZIP code, it won’t take long to see what’s available to you.