What Medicare Advantage Plans does Humana Offer?

Last Updated : 10/21/20185 min read

Humana markets Medicare Advantage plans in many states across the country. Also, Humana offers a wide range of choices to satisfy the medical needs, preferences, and budgets of many different Medicare beneficiaries. Whether you’re new to Medicare, or thinking about changing your Medicare coverage, you may want to take a look at Humana’s Medicare Advantage plans.

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Kinds of Humana Medicare Advantage plans

Under the Medicare Advantage (Medicare Part C) program, private insurance companies that contract with Medicare – such as Humana – offer Medicare Advantage plans, which include the same benefits you get under Original Medicare. The exception is hospice care, which Medicare Part A covers even if you’re enrolled in a Medicare Advantage plan.

Humana’s Medicare Advantage plans, like other Medicare Advantage plans, often bundle in Medicare Part D prescription drug coverage, and may also have some additional benefits that aren’t found in Part A and Part B, like routine dental coverage or membership in an exercise program.

Here are some of the more popular kinds of Medicare Advantage plans that Humana offers. Note that not every type of plan may be available in your specific location.

HMO: A Health Maintenance Organization, or HMO, typically requires that you receive care from providers in the plan network. Humana’s website can help you find network doctors and other health providers within your plan’s service area. Except for urgent or emergency health care, generally you must use one of these network medical providers to get services covered. You usually also have to select a primary care doctor, and you may need a referral from that doctor to see specialists. Typically, HMOs do a good job of containing costs for insurers and members, so they are popular in some areas.

PPO: A Preferred Provider Organization, or PPO, is another kind of managed care plan. You get the highest level of coverage by visiting network providers. The plan may still cover Medicare-covered services if you chose a provider outside of the network, but you generally have to pay more for non-network services. Typically, you won’t need to choose a primary care doctor and are free to schedule appointments with specialists without a referral. PPOs are more flexible than HMOs, but can be somewhat more expensive.*

PFFS: PFFS stands for Private-Fee-for-Service. These Medicare Advantage plans (from Humana or other Medicare-approved insurance companies) determine their own provider payment structures and member out-of-pocket costs. With many PFFS plans, you are welcome to choose any medical providers as long as they accept the terms and conditions that the plan sets. Other PFFS plans have provider networks. This kind of plan might offer you more flexibility than other types of Medicare Advantage plans, but it’s important to make sure your doctors and other caregivers accept the plan’s payment terms.

Plan costs and availability may vary, along with specific details of benefits beyond Medicare Part A and Part B. No matter what type of Medicare Advantage plan you sign up for, you’re still in the Medicare program, and you need to continue paying your monthly Medicare Part B premium.

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Learn more about Medicare Advantage plans from Humana

Are you interested in learning more about Humana Medicare Advantage plans? Check out the Humana page. Or, to compare your options right away, click the Find Plans button 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.

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, 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.

***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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