Humana & Medicare Advantage
Humana offers a wide range of plan types, from health maintenance organization (HMO) to preferred provider organization (PPO) or special needs plans (SNP) — all of which have different advantages, benefits, costs and qualifications.
- Written by Michael Jones
Medicare Expert and Owner of Grand Anchor Insurance Solutions
Michael Jones is a licensed insurance agent who manages his own agency called Grand Anchor Insurance Solutions. In addition to being a Medicare expert, Michael specializes in other insurance products such as voluntary benefits for employees of businesses.Read More
- Edited ByMichael Santiago
Senior Financial Editor
Michael Santiago, a senior financial editor, joined RetireGuide in 2023. With over 10 years of professional writing and editing experience, he brings a wealth of expertise in creating content for diverse industries, including travel and healthcare. Having traveled to more than 40 countries across five continents and lived in Europe and Asia for several years, Michael's global perspective enriches his work. He combines his strong writing skills, editorial judgment and passion for crafting accurate and engrossing content to enhance the user experience on RetireGuide.Read More
- Financially Reviewed ByEric Estevez
Owner of HLC Insurance Broker, LLC
Eric Estevez is a duly licensed independent insurance broker and a former financial institution auditor with more than a decade of professional experience. He has specialized in federal, state and local compliance for both large and small businesses.Read More
- Published: October 15, 2021
- Updated: October 18, 2023
- 5 min read time
- This page features 9 Cited Research Articles
- Edited By
- Humana is a national company, providing broad coverage across the U.S. However, some plans may not be available in all states, so it is essential to compare plans and find the best fit for your needs.
- Humana offers various types of Medicare Advantage plans that cover everything included in Original Medicare and often provide additional benefits such as vision, dental and hearing coverage.
- Humana has a strong track record of customer satisfaction, ranking number one among health insurers for customer experience in a comprehensive survey.
- The majority of Humana’s 2023 Medicare Advantage plans have 4-star ratings or higher, with some plans classified as high performing by the Centers for Medicare & Medicaid Services.
Humana Medicare Advantage Plan Coverage
Medicare Advantage plans of all types must include everything that is covered under Original Medicare. These plans often include additional benefits or coverage on top of what you could get through Original Medicare. There are several types of plans available through Humana.
Health maintenance organization (HMO) plans are a common Medicare Advantage option for beneficiaries offered by Humana. If you choose to go with an HMO, remember that you will likely have to remain within the network of your plan. You may also need a referral from your primary care physician to receive care from a specialist.
Humana HMO plans come with some added financial security since they can have a maximum out-of-pocket cost for each year, ensuring that you’ll never have to spend over a certain amount even in a medical emergency.
You typically will have unlimited primary care physician visits and many plans also include an over-the-counter allowance for purchasing things like first aid kits. As with other Medicare Advantage options, these plans usually include coverage for vision, dental and hearing as well.
If you opt for a preferred provider organization (PPO) plan from Humana, you are not required to stay within a network to receive care. The trade-off is that your costs will likely be higher if you choose to do this.
Like with an HMO Plan, you should be able to receive vision, dental, hearing and prescription drug coverage as well as everything included in Original Medicare. You should also have access to annual screenings and added benefits like fitness programs and even emergency coverage outside the U.S.
Private Fee-for-Service (PFFS) Plans
A Humana private fee-for-service (PFFS) plan offers you the flexibility to go to any doctor if they participate in Medicare, instead of being limited to what is available through your specific plan. Your PFFS plan will determine how much you must pay after receiving treatment or service from a doctor.
Special Needs Plans (SNPs)
A special needs plan (SNP) is designed for people who have specific diseases or qualifying conditions and exists to offer them coverage and support those needs. SNPs can offer benefits catered to the specific conditions that they cover. These plans include everything covered under Part A and Part B as well as prescription drug coverage.
To qualify, you must be eligible for both Medicare and Medicaid, have a qualifying condition or live in a skilled nursing facility.
- Cardiovascular Disorders
- Chronic Heart Failure
- Chronic Lung Disorders
- Diabetes Mellitus
Humana may not offer the best plan for every individual’s specific needs. You should consult with your advisor to determine whether a Humana plan is the right fit for you.
Average Cost of Humana Medicare Advantage Plans
The cost of your plan will depend on where you live, the number of plans available in your area and which type of plan you are purchasing. In 2023, 62% of Humana’s Medicare Advantage plans come with a premium of $0, helping to keep your Medicare Advantage plan costs down. You must still pay your Part B premium. Consolidated premiums, which include Part C and Part D coverage, range from $4 to $199 per month.
A Medicare advisor can help you compare plans among the various companies that sell Medicare Advantage plans.
In order to scale, many sales organizations focus heavily on recruiting. The insurance industry is no different, having a large presence of multi-level marketing organizations. While, this is not inherently a bad thing, it is increasingly important to vet out your chosen insurance agent. Years of experience, licenses held and area of specialization can tell you a lot about who you are choosing to work with.
Pros and Cons of Medicare Coverage From Humana
As with most plans, there are both pros and cons to opting for Humana.
As far as cons go, while the insurance company itself is available all over the country, certain plans may not be. For example, SNPs are not available in every county and there may be limitations on the type of condition covered. You may also have to be dually enrolled in Medicaid to be eligible for some SNPs.
For the pros, one major advantage for Humana is its status as a national company with availability across the U.S. This can offer more security than you might get from a more regional option and ensures that some form of coverage is likely available where you live.
Another pro is that Humana’s customer satisfaction tends to be high. Forrester awarded Humana the top spot for customer satisfaction among health insurers in its comprehensive 2022 US Customer Experience Benchmark survey.
Average Rating of Humana
Humana typically has solid Medicare Star ratings. According to the company, 96% of its 2023 plans rate four stars or higher. Currently, more than three million members spread across 46 states and Puerto Rico are covered by contracts with a 4.5-star rating.
In addition, three of Humana’s plans were classified as High Performing Icons by the Centers for Medicare & Medicaid Services (CMS) in 2023.
9 Cited Research Articles
- U.S. Centers for Medicare & Medicaid Services. (2023, February 14). Prescription Drug Coverage – General Information. Retrieved from https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn
- Humana. (2022, November 10). U.S. News and World Report names Humana 2023 Best Overall Medicare Advantage Plan Company. Retrieved from https://press.humana.com/news/news-details/2022/U.S.-News-and-World-Report-names-Humana-2023-Best-Overall-Medicare-Advantage-Plan-Company/
- Humana. (2022, October 7). 96% of Humana’s Medicare Advantage Members are in Contracts rated 4-Star of Above for 2023; 66% are in Contracts Rated 4.5 Star or Higher. Retrieved from https://humana.gcs-web.com/news-releases/news-release-details/96-humanas-medicare-advantage-members-are-contracts-rated-4-star
- U.S. Centers for Medicare and Medicaid Services. (2022, October 6). 2023 Medicare Advantage and Part D Star Ratings. Retrieved from https://www.cms.gov/newsroom/fact-sheets/2023-medicare-advantage-and-part-d-star-ratings
- Business Wire. (2022, August 1). Humana ranked No. 1 among health insurers for Customer Experience. Retrieved from https://www.businesswire.com/news/home/20220801005587/en/humana-ranked-no.-1-among-health-insurers-for-customer-experience
- Jacques, P. (2022, June 1). The US Customer Experience Index Rankings, 2022. Retrieved from https://www.forrester.com/report/the-us-customer-experience-index-rankings-2022/res177585
- Humana. (n.d.). Over-the-counter (OTC) allowance Benefit. Retrieved from https://www.humana.com/pharmacy/over-the-counter-otc-benefits
- Humana. (n.d.). Understanding Medicare’s out-of-pocket costs. Retrieved from https://www.humana.com/medicare/medicare-resources/medicare-out-of-pocket-cost
- U.S. Centers for Medicare and Medicaid Services. (n.d.). Understanding Medicare Advantage Plans. Retrieved from https://www.medicare.gov/Pubs/pdf/12026-Understanding-Medicare-Advantage-Plans.pdf
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