Tuesday, May 21, 2024

Is Humana Choice A Medicare Advantage Plan

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Humana: How to choose a Medicare Plan that’s right for you

In addition to premiums, plan members are also responsible for paying a deductible and coinsurance with Original Medicare. The 2022 deductible for inpatient hospital stays is $1,556 per benefit period. The annual deductible for Part B is $233. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services.

Things To Keep In Mind About Humana Medicare Advantage

  • Plan availability varies by location. Where you live will impact which plans are available to you and which extra benefits you receive.
  • Benefits vary by plan. Extras and perks vary depending on which plan you choose. Be sure to read all plan details and thoroughly compare your options before choosing.

Humana Medicare Advantage Ppo Plan Benefits

A Humana Medicare Advantage PPO plan offers all of the same coverage as Original Medicare, which includes Medicare Part A and Medicare Part B , and it may include a number of additional benefits that Original Medicare doesnt cover.3

These additional benefits may include:

  • Coverage for dental, hearing and vision care
  • Prescription drug coverage4
  • Gym and wellness program memberships
  • Access to Mail-order pharmacies that ship to your home

Numerous annual preventive tests and screenings are covered in full at no additional cost to members. In-network home healthcare may also be offered.

The prescription drug coverage that is offered by certain Humana PPO plans is equal to or even better than the standard requirement for Medicare Part D prescription drug plans.

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Which Drugs Are Covered By Humana Medicare Plans

Humana Medicare plans cover a wide range of prescription drugs including everything from commonly prescribed generic drugs to rare, brand-name specialty medications.

A Humana drug formulary is divided into five different tiers of drugs and each tier may be covered differently under each Humana PDP plan.

  • Tier 1 – Preferred, low-cost generic drugs
  • Tier 2 – Non-preferred and low-cost generic drugs
  • Tier 3 – Preferred brand-name and some higher-cost generic drugs
  • Tier 4 – Non-preferred brand-name and some non-preferred high-cost generic drugs
  • Tier 5- Highest-cost drugs including most specialty medications

Speaking to a licensed insurance agent is one way to determine if the drug you are taking is covered by a Humana plan.

Humana Medicare Advantage Plans Review

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Humana started in 1961 as a nursing home company. Today, Humana Inc. is an American health insurance company based in Louisville, Kentucky, that serves millions of customers. It’s also one of the many health insurance companies in the United States that offers Medicare Advantage plans. More than 4 million people across all 50 states and Washington, D.C., are enrolled in one of Humana’s Medicare Advantage plans1.

If you’re ready to enroll in Medicare, Humana may have a Medicare Advantage plan that works for your medical needs and budget. Humana’s Medicare Advantage plans, also called Medicare Part C, include Medicare Part A, Part B, and sometimes Part D benefits. Humana’s plans may help you save money or enjoy extra perks like hearing care, dental care, insulin savings, or a SilverSneakers membership.

This guide will cover everything you need to know about Humana’s Medicare Advantage plans, including plan types, costs, and ratings and reviews.

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What Are Humana Medicare Advantage Plan Options

Humana offers nearly a dozen plans, including HMOs, PPOs, PFFS plans, and SNPs. Some plans dont have monthly premiums and have relatively affordable out-of-pocket costs, with visits to primary care doctors ranging from $0 to $15 and visits to specialists from $20 to $45. In addition to covering medical and hospital care, all plans include memberships for SilverSneakers, and many have an allowance for over-the-counter medications. Plans vary depending on your location. Check available options in your area.

These are among the most popular Humana Medicare Advantage Plans:

Humana Medicare Advantage Plans

*Based on pricing in Chicago, IL in 2022

Humana Walmart Value Rx Plan

Under the Humana Walmart Value Rx Plan, Humana teams up with Walmart, Walmart Neighborhood Markets, and Sams Club pharmacies as its preferred cost-sharing partners.

This lets Humana offer additional prescription savings to people who purchase their medications at Walmart.

The Humana Walmart Value Rx Plans benefits include:

  • $17.20 monthly plan premium nationwide
  • $0 deductible on tier 1 and 2 medications
  • $445 annual deductible on tiers 3 through 5 medications
  • in-store copays as low as $1 on a 30-day supply of certain generic drugs at Walmart, Walmart Neighborhood Markets, and Sams Club
  • copays as low as $3 on a 90-day supply of tier 1 preferred generics through Humanas mail-delivery pharmacy
  • more than 3,500 medications on the plans list of covered drugs

Before choosing the Humana Walmart Value Rx Plan, make sure you live near a Walmart location that features pharmacy services. While you are able to use other pharmacies under this plan, you wont get additional discounts if you dont use Humanas preferred cost-sharing partners.

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How To Enroll In A Medicare Advantage Plan

Your first chance to sign up for Medicare Advantage is during your . The IEP for Medicare starts 3 months before the month you turn 65 and ends 3 months after.

If you are already enrolled in Medicare Advantage, you can switch plans during the . The Medicare Advantage OEP runs from Jan. 1 to March 31, or the annual enrollment period for Medicare.

If you have Original Medicare and want to enroll in Medicare Advantage for the first time, you can choose a Medicare Advantage plan during . Medicares AEP runs from Oct. 15 to Dec. 7.

Original Medicare Vs Medicare Advantage: One Big Difference

Medicare Advantage And Prescription Drug Plan

Theres one difference between Original Medicare and Medicare Advantage that really stands out: Medicare Advantage plans have a yearly limit on what youll pay.

This is called your maximum out of pocket . Once you reach this limit, youll pay nothing for approved services that your plan covers for the rest of the year.For 2021, the MOOP is $7,550 .

Original Medicare has no limit on what you pay. This means that if you have a health crisis, your costs could skyrocket. If you prioritize peace of mind and want assurance that youll never be burdened with unexpected medical bills, a Medicare Advantage plan may be best for you.

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More Articles About Humana Plans

1 $0 premium plans may not be available in all areas.

2 Humana Inc. Humana Reports Second Quarter 2021 Financial Results Maintains Full Year 2021 Adjusted EPS Financial Guidance. . Retrieved from https://humana.gcs-web.com/static-files/e12df80f-be23-47ec-b388-5e917524690e.

3 Humana. Humana Medicare Advantage PPO plans. Retrieved from www.humana.com/medicare/medicare-advantage-plans/humana-choice-ppo.

4 Humana Medicare Advantage HMO plans. Retrieved from www.humana.com/medicare/medicare-advantage-plans/humana-gold-plus-hmo.

5 Humana. Humana private-fee-for-service plans. Retrieved from www.humana.com/medicare/medicare-advantage-plans/humana-choice-pffs.

6Humana. Humana Medicare Advantage Special Needs plans . Retrieved from www.humana.com/medicare/medicare-advantage-plans/humana-special-needs

7 TZ Insurance Solutions LLC/TruBridge licensed agents who may call you are not direct employees of Humana and are not connected with or endorsed by the U.S. Government or the federal Medicare program.

8 According to internal data from TZ Insurance Solutions in 2020.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC is a licensed and certified representative of Medicare Advantage HMO, PPO and PFFS organizations and stand-alone prescription drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal.

To learn more about a plans nondiscrimination policy, please click here.


Humana Premier Rx Plan

Like the Walmart Value Rx Plan, the Humana Premier Rx plan also uses Walmart as its preferred cost-sharing partner. This means that living close to a Walmart location is key to saving the most on your prescriptions.

While this plan has a higher premium than the Walmart Value Rx Plan , the Humana Premier Rx Plan includes additional benefits:

  • $0 deductible on tier 1 and 2 medications
  • $0 copay on 90-day supplies of tier 1 and 2 medications from Humanas mail-delivery pharmacy service
  • preferred cost-sharing at Humana Pharmacy, Walmart, Walmart Neighborhood Markets, Sams Club, Publix, Kroger, Harris Teeter, HEB, and Costco pharmacies
  • $445 annual deductible on tiers 3 through 5 medications nationwide and $305 in Puerto Rico
  • more than 3,700 medications on the plans list of covered drugs

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We Offer Online Enrollment For 2021 Humana Medicare Advantage Plans

Humana Medicare Advantage plans combine the standard coverage of Original Medicare with the broader benefits of a private Medicare plan. These plans vary in coverage and cost. But many come with benefits you wont find under Original Medicare, such as prescription drug coverage, dental and vision insurance, telemedicine & more.

How Much Do Medicare Advantage Hmo Plans Cost

Humana Medicare Advantage Plan TV Spot,

If the potential cost of your healthcare is your most important concern, our Medicare Advantage HMO plans may t the bill.

  • Affordable monthly premiums – as low as $0 and affordable copays when you visit in-network providers
  • Unlimited PCP visits – with most Medicare HMO plans youre covered for unlimited medical doctor visits with affordable copayments, so you can see your PCP as often as you need to
  • Affordable deductibles – and using in-network providers from our broad networks may help you save even more
  • Potential Part B premium savings – some Medicare HMO plans offer rebates on the $148.50 Part B premium
  • Over-the-counter allowance – many Medicare HMO plans include an allowance that lets you order general healthcare itemslike pain relievers, rst aid items, even safety grab bars for your showerthrough our OTC catalog at no additional cost to you
  • The security of an annual maximum out-of-pocket cost – for 2021, our average HMO maximum out-of-pocket limit is $4,679. Once youve spent the limit, youll pay nothing for services covered by your plan until the end of your plan year

Also Check: When Do I Qualify For Medicare Insurance

How Much Does Medicare Advantage Cost

With Medicare Advantage options, instead of paying your healthcare bills directly, the federal government pays private insurance companieslike Humanato administer your coverage.

While there is a monthly premium for Medicare Advantage options, many private insurance companies choose to offer affordable or $0 plan premiums to compete for your business. They also set the guidelines for your deductible, coinsurance and copays. To learn about Medicare Advantage options from Humana, you can .

As with Original Medicare members, Medicare Advantage members must continue to pay their Part B premium.

Do Humana Ppo Plans Have A Network Of Providers

The Humana Medicare Advantage PPO plans consist of broad networks of health care providers.

As a plan member, you can visit the in-network doctor of your choice. You are also free to receive Medicare-approved care outside of the plan network, as long as your doctor is approved by Medicare and accepts Humanas plan terms.

Theres no need to get a referral in order to see a specialist, so you can take control of your health and seek out the care you need.

Monthly premiums for office visits can be as low as $0 in some areas, depending on your plan.1

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Competition: Humana Vs Unitedhealthcare

Humana and UnitedHealthcare are the Medicare Advantage plans with the broadest geographical coverage 88% of counties have Humana options, 74% have UnitedHealthcare, and 68% have both. UnitedHealthcare is the nations largest health insurer, with more than 14% market share.

UnitedHealthcare also has an exclusive partnership with AARP, giving it a unique advantage in a trusted brand affiliation. UnitedHealthcare has slightly higher average Star Ratings, but both companies offer online tools or apps and multiple channels for customer support. UnitedHealthcare helps members choose a plan with customized recommendations and cost estimators.

In a head-to-head comparison, the difference may come down to specific quality ratings in your local area and cost, which vary depending on where you are.

What States Offer Humana Medicare Advantage Plans

Humana: How to choose a Medicare Plan that’s right for you

Humana offers Medicare Advantage plans in 49 states. Medicare Advantage plans are not currently sold in Alaska.

Although there is wide availability throughout the country, specific types of plans and coverage options may only be offered in certain areas. This means that if your relative in another state has a Humana plan, the same plan might not be available to you.

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How Medicare Pffs Plans Work

A Medicare PFFS plan is a type of Medicare Advantage plan offered by a private insurance company. PFFS plans arent the same as Original Medicare or Medicare Supplement plans. With a Medicare PFFS plan, the plan determines how much it will pay doctors, other healthcare providers and hospitalsand how much you must pay when you get care.

Explore plans

Humana Medicare Advantage Plans Reviews And Ratings

Humana rates consistently well across several review sites, with customers noting its professionalism, reliable coverage, and large provider networks. Humana received lower marks for coverage limits, especially related to prescription drugs.

Trusted ratings and reviews can help you understand how an insurers plans stack up against the competition. See how Medicare, A.M. Best, the Better Business Bureau and more rate Humana Medicare Advantage Plans.

LeRon Moore has guided Medicare beneficiaries and their families as a Medicare professional since 2007. First as a Medicare provider enrollment specialist and now a Medicare account executive, Moore works directly with Medicare beneficiaries to ensure they understand Medicare and Medicare Advantage Plans.

Moore holds a bachelors degree from Southern New Hampshire University and is A+ Certified with a Medical Records Clerk Certification and Medical Terminology Certification from Midlands Technical College.

Hes passionate about educating, informing, and resolving issues concerning Medicare and Medicare Advantage Plans, and considers it imperative that he does all he can to educate and inform the senior community as much as possible about Medicare.

Moore holds a bachelors degree from Southern New Hampshire University and is A+ Certified with a Medical Records Clerk Certification and Medical Terminology Certification from Midlands Technical College.

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Humana Special Needs Plans

Humana also offers special needs plans 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, SilverSneakers membership, and a Healthy Foods Card.

Humana’s Chronic Condition SNPs cater to older adults 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. The plan combines your Medicare and Medicaid benefits in one plan that’s easy to manage.

Humana’s SNP plans are best for older adults 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

FYI: Humana also offers 9 out of the 10 standard Medigap plans to supplement your Original Medicare. Options vary based on your location. For more details, check out our Humana Medigap plans review.

What Do Humana Medicare Advantage Plans Offer

Humana Medicare Plan TV Commercial,

Humana Medicare Advantage Plans offer private insurance to Medicare beneficiaries. As with all Medicare Advantage plans, these plans offer the same coverage that Original Medicare Parts A and B provide, but may also come with additional benefits, like dental and vision care as well as a variety of non-medical perks. Read on for more about Humana’s Medicare Advantage offerings.

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Compare Medicare Advantage Plans

The benefits of Medicare Advantage plans can make them a great alternative to Original Medicare. However, its important to understand the differences of each plan before making a decision.

To help you choose whats best for your needs, let’s take a look at the types of Medicare Advantage plans and how they compare.

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So how do we make money? Our partners compensate us. This may influence which products we review and write about , but it in no way affects our recommendations or advice, which are grounded in thousands of hours of research. Our partners cannot pay us to guarantee favorable reviews of their products or services.Here is a list of our partners.

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Humana Medicare Plans Offer Something For Everyone Value With Humana Choice

Humana has a great deal to offer in the Medicare market. Whether you are looking for a Medicare supplement or a Medicare Advantage plan, you can find it in a Humana Medicare plan.

One popular option is Humana Choice. This is a Medicare Advantage plan that offers a good value. Humana has consistently offered several options in the Medicare Advantage arena.

Dont confuse a Medicare Advantage plan with a Medicare supplement. An Advantage plan is another way for you to receive your Medicare benefits. This is when a private insurance company contracts with CMS to administer your Medicare. You will pay co-pays, co-insurance and in some instances deductibles. Your out-of-pocket expenses can often be controlled or limited with an Advantage plan.

Humana Medicare plan options also include Medicare supplements. A supplement, or Medigap policy, will fill the gaps left by Medicare in return for you paying a monthly premium. Premiums for Medicare supplements are often much higher than premiums for a Medicare Advantage plan. Humana Medicare plans are no exception.

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