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What Medicare Advantage Plans Does Humana Offer?


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The Medicare Advantage (Medicare Part C) program is an alternative way to get your Original Medicare, Part A and Part B, benefits. Medicare Advantage plans cover everything that Original Medicare covers (besides hospice care, but that’s still covered by Part A). They’re available from private, Medicare-approved insurance companies like Humana.

Many of Humana’s Medicare Advantage plans offer coverage beyond Part A and Part B benefits to help manage your health-care costs. For example, Medicare Advantage plans from Humana usually include prescription drug coverage. Humana also offers health-care plans that you can add to your Humana Medicare Advantage plans. These add-on plans may include such benefits as routine vision and dental care, or fitness programs. Availability of these additional benefits may vary.

If you’re looking at your Medicare plan options, you may want to consider one of Humana’s Medicare Advantage plans that is offered in your service area. Keep in mind that not every Humana Medicare Advantage plan may be available in every area, and plan premiums and details may vary depending on where you live.

What types of Medicare Advantage plans are available from Humana?

Humana is a private insurance company contracted with Medicare to provide benefits to its members. These are some of the kinds of Medicare Advantage plans Humana offers, but again, not every plan type may be available where you live.

  • Humana Medicare Advantage Health Maintenance Organization (HMO) plans. HMO plans usually offer more predictable health-care expenses than other types of Humana Medicare Advantage plans, but they generally require you to get all your routine medical care from network providers (medically necessary emergency care is covered even if you receive that care out-of-network, however). A primary care provider whom you select from the plan network oversees your care, and you may need a referral to see a specialist. The Humana Gold Plus HMO plan includes coverage for prescription drugs. Out-of-pocket costs may be lower with an HMO than with other types of Medicare Advantage plans.
  • Humana Medicare Advantage Preferred Provider Organization (PPO)* plans. PPOs are more flexible than HMOs; you can see any provider who accepts Medicare and agrees to bill the plan, and you do not need to select a primary care provider. Many HumanaChoice PPOs encourage you to use providers in your plan’s network by offering lower out-of-pocket health-care costs when you stay in-network. In many cases, you get prescription drug coverage with PPOs, as well. PPOs offer a balance between flexibility and lower out-of-pocket costs.
  • Humana Medicare Advantage Private Fee-for-Service Plans (PFFS). Humana Gold Choice PFFS plans let you see any provider who accepts Medicare and the terms of your plan, giving you maximum flexibility, especially if you travel frequently. Some PFFS plans have networks, and you might save money by using a provider within the plan’s network.Many PFFS plans offer coverage for prescription drugs in addition to all the benefits under Original Medicare (other than hospice care, which is still covered under Medicare Part A). It’s important to note that not every provider will accept a PFFS Medicare Advantage plan’s payment terms, even if he or she generally accepts Medicare assignment. You may want to ask if the provider accepts these terms before you get treatment, so you can avoid financial responsibility for the entire cost of your care.

You must continue to pay your Part B premium when you are enrolled in any Medicare Advantage plan (from Humana or any insurance company), plus any additional monthly premium your plan may require. Copayments, coinsurance amounts, deductibles, and premiums may vary by plan type and location.

Can I get routine vision or dental care with a Medicare Advantage plan from Humana?

Some Humana Medicare Advantage plans include coverage for routine dental and vision services like cleanings and annual exams. Humana also offers optional supplemental benefits that may be added to your Humana Medicare Advantage plan at any point during the year in most cases. Humana offers several different additional benefit plans, although these plans may only be added to certain Humana Medicare Advantage plans and availability may vary:

  • Humana MyOptionSM Dental plans cover 100% of routine in-network care, plus partial coverage for major dental services – the amount of coverage depends on which Humana MyOptionSM Dental plan you enroll in. Annual benefit limits may apply.
  • Humana MyOptionSM Vision plans cover an annual routine eye exam at no charge if you go to a provider within the EyeMed Select network. The plans offer partial coverage of prescription lenses and frames, or contact lenses.
  • Humana MyOptionSM Fitness plans, which include the Silver Sneakers program. This program gives you access to fitness classes and exercise equipment (specifics vary among plans).

Again, not every supplemental benefits option may be available in every area or combined with every type of Humana Medicare Advantage plan. There may be an additional premium for any optional benefits package you select.

You can compare Humana Medicare Advantage plans in your community anytime you like – just fill out your zip code where indicated at the top of this page, or give a licensed insurance agent a call at 1-888-519-2029 (TTY users dial 711) Monday through Friday, 8AM – 8PM Eastern time.

*Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan 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 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.

Humana’s pharmacy network offers limited access to pharmacies with preferred cost sharing in urban areas of < AL, CA, CT, DC, DE, IA, IL, IN, KY, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NH, NJ, NY, OH, OR, PA, RI, SC, SD, TN, VA, VT, WA, WI, WV; suburban areas of AZ, CA, CT, DE, HI, IL, MA, MD, ME, MI, MN, MO, MT, ND, NH, NJ, NY, OH, OR, PA, PR, RI, VT, WA, WV >; and rural areas of < AK, IA, MN, MT, ND, NE, SD, VT, WY > . There are an extremely limited number of preferred cost share pharmacies in urban areas in the following states: < DE, MA, MD, ME, MI, MN, MS, ND, NY, OH, SC, and VT> ; suburban areas of: < MT and ND > ; and rural areas of: < ND >. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including pharmacies with preferred cost sharing, please call Customer Care at <1-800-281-6918 (TTY: 711)> or consult the online pharmacy directory at Humana.com.

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.

This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

 

Last Updated Date: 7/30/2017

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