What Medicare Plans Does Humana Offer?
Last Updated : 10/21/20188 min read
The federal government provides Original Medicare, Part A and Part B, but private companies like Humana contract with the Medicare program to offer additional coverage or an alternative way to get your Original Medicare benefits.
Medicare plans offered by Humana include Medicare Advantage plans, stand-alone Medicare Part D Prescription Drug Plans, and Medicare Supplement plans, also called Medigap plans.
Here’s an overview of each of these types of coverage.
What Medicare Advantage plans are available from Humana?
Medicare Advantage plans (such as those Humana offers) are an alternative way to get all the coverage of Original Medicare (except for hospice care, which is still provided under Part A) in a different way. Many plans, known as Medicare Advantage Prescription Drug plans, also include prescription drug coverage (Part D), letting you get all of your Medicare benefits under one convenient plan. Some of these Medicare Advantage plans from Humana may include extra coverage for routine vision, dental, hearing care, and even wellness programs. Depending on where you live, you may be eligible to enroll in one of these types of Humana Medicare Advantage plans:
- Humana Gold Plus Health Maintenance Organization (HMO) plans, which require you to use network providers and get referrals from your primary care doctor for specialist care.
- Humana Choice Preferred Provider Network (PPO) plans, which pay for more of your costs when you use network providers. However, you may have the option to use non-network providers but you might pay higher copayments and coinsurance costs if you do go out-of-network. You don’t need referrals for specialist services.*
- Humana Gold Choice Private Fee-For-Service (PFFS) plans, which let you use providers that accepts your plan’s terms and conditions and agree to treat you. Keep in mind that providers that have not contracted with the plan are not required to treat you (with the exception of emergency care).
Keep in mind that you must continue to pay your Part B premium if you enroll in a Medicare Advantage plan; your plan may also require an additional monthly premium for your Medicare Advantage coverage. Not all plans are available in all locations, and plan benefits and premiums may vary depending on where you live.
What Medicare Part D Prescription Drug Plans are available from Humana?
Medicare plans available from Humana also include stand-alone Medicare Part D Prescription Drug Plans, which provide prescription drug benefits if you’re enrolled in Original Medicare (Part A and/or Part B). Each of these plans must provide minimum benefits mandated by the Medicare program; for example, each Medicare Prescription Drug Plan (PDP) must cover at least two prescription drugs from certain required drug classes. Like Medicare Advantage Prescription Drug plans, these plans use a formulary, or list of covered prescription drugs, to determine coverage; the plan may change its formulary at any time, but it must notify you before any change occurs.
Stand-alone Medicare Part D Prescription Drug Plans offered by Humana in your vicinity may include the following:
- The Humana Walmart Rx Plan (PDP) is an economical option that features low premiums, no deductible on Tier 1 and Tier 2 prescription drugs, and low cost-sharing (as low as $1 on Tier 1 and Tier 2 drugs) if you use a Walmart, Walmart Neighborhood Market, or Sam’s Club pharmacy.
- The Humana Preferred Rx Plan (PDP) may offer preferred cost-sharing if you use certain Walmart, Walmart Neighborhood Market, or Sam’s Club pharmacies and has a deductible.
- The Humana Enhanced Plan (PDP) features no deductible and a comprehensive prescription drug formulary.
If you qualify for Extra Help under the Medicare Part D program, you might not have to pay a premium for your Medicare Prescription Drug Plan.
Some Medicare Part D Prescription Drug Plans that Humana offers may require you to use network pharmacies to access benefits, and some use a tiered formulary, in which lower-tiered medications are offered at a lower copayment, in some cases without a deductible requirement, while higher-tired medications have a higher copayment, coinsurance, and/or deductible requirement.
In general, Medicare Part D Prescription Drug Plans (from Humana or any other company) may not be combined with any Medicare Advantage plan that includes prescription drug coverage; in fact, if you enroll in one while you are covered by a Medicare Advantage plan with prescription drug benefits, you will be automatically removed from your Medicare Advantage plan and returned to Original Medicare. The exception is if you are enrolled in a type of Medicare Advantage plan that doesn’t include prescription drug benefits (such as a Medicare Savings Account plan); in this case, you’re allowed to enroll in a stand-alone Prescription Drug Plan for your Part D coverage.
Plans and benefits may vary by location, and you may be required to pay an additional monthly premium in addition to your Part B premium. It’s important to get Part D prescription drug coverage as soon as you are eligible, or you may have to pay a late-enrollment penalty with your monthly premium for as long as you have coverage. If you go without Part D after you’re first eligible and don’t have other creditable prescription drug coverage (insurance that covers at least as much, on average, as the Part D benefit), you may owe a late-enrollment penalty when you sign up for this coverage later on.
Are there Medicare Supplement plans available from Humana?
Depending on where you live, you may be able to purchase a Medicare Supplement, or Medigap plan, from Humana to help cover certain out-of-pocket expenses under Original Medicare. These may include costs that you’re normally responsible for, such as copayments, coinsurance, deductibles, overseas emergency health coverage, and Part B excess charges. Plan benefits are regulated by the state and federal government; there are 10 types of standardized Medigap plans available in most states, and each plan is labeled A through N depending on the type of coverage provided. Medicare Supplement plans may vary from state to state and not all plans may be available in all locations.
As you can tell, there are many types of Medicare coverage available to help with your different needs. If you’d like to learn more about Medicare plan options available from Humana, you can browse plan options via the Humana page. Or, just click on the Find Plans button to get started right away.
*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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