How Can I Find Healthcare Providers Who Accept Medicare Advantage Plans Offered by Humana?
Last Updated : 10/21/20185 min read
Some Medicare Advantage plans available from Humana require you to use providers in the Humana plan’s network to access your plan benefits and minimize your out-of-pocket costs. Here’s how to find Humana providers in your area.
Why do I need to use network providers?
Humana is one of the private companies approved by Medicare to offer health-care benefits under the Medicare Part C (Medicare Advantage) program.
Although these companies are required to meet minimum coverage requirements for their enrollees as set by Medicare, they may limit plan members to seeing a select group of providers in order to control costs and provide high-quality health care.
Medicare providers in Humana networks may include primary care doctors, specialists, hospitals, pharmacies, outpatient clinics, laboratories, imaging centers, and in some cases, even dentists, eye doctors, and audiologists. These providers contract with Humana’s Medicare health and prescription drug plans to provide covered services at specific costs. These costs may be lower than what you would pay if you stayed with Original Medicare (Part A and Part B), getting your benefits directly through the government instead of through a Medicare Advantage plan.
Humana’s network providers agree to accept the copayment or coinsurance amount specified in your Humana plan as payment in full for your share of your health-care expenses for Medicare covered services.
Some of Humana’s Medicare Advantage plans require you to get most or all of your care from contracted Humana providers, unless you get medically necessary emergency treatment, which is generally covered even when provided by out-of-network doctors and hospitals. If you don’t use Humana’s network Medicare providers, you may need to pay the full cost of your care. Different plans have different rules; for example, some Humana’s Medicare Advantage plans are Preferred Provider Organizations (PPOs),* which might let you use providers outside the plan network (often at a higher cost to you).
How do I find Humana providers?
Humana makes it easy for you to find providers who accept your Humana Medicare health plan. Humana’s online provider search tool lets you search by your Humana ID number or plan name, and filter results by the type of provider you are looking for.
If you use a tablet or smartphone, you can also download the free MyHumana mobile app and use the built-in search tool included in the app. The mobile app also includes features to help you manage your Humana plan benefits, such as viewing claims, ordering ID cards, and reviewing your plan coverage and benefits.
Will I save money if I use Humana providers?
Indeed, one important reason for using Humana network providers is because they might save you money when you access health care. Your Humana plan may cover a higher percentage of your costs, for example, or your copayment or coinsurance amounts may be lower when you use in-network providers.
If you are using a new provider for the first time, even if the provider is listed on the Humana website, it’s always a good idea to verify that your plan is still accepted and the copayment or coinsurance amount you are responsible for when you get care. This helps you manage your out-of-pocket costs and avoid any unexpected bills at the time of your appointment.
Are you thinking about signing up for a Medicare Advantage plan from Humana? Remember that you need to stay enrolled in Medicare Part A and Part B, and continue paying your Part B premium. Simply visit the Humana Medicare page to learn more. If you’re ready to see some plans right now, use the Find Plans buttons on this page.
*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. [Benefits, premiums and/or member cost-share] may change on January 1 of each year. The [Formulary, pharmacy network, and/or provider network] may change at any time. You will receive notice when necessary.
**Out-of-network/non-contracted providers are under no obligation to treat <Plan/Part D Sponsor> 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 Inc. and its subsidiaries (“Humana”) do not discriminate on the basis of race, color, national origin, age, disability, or sex.
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