Humana Medicare Plans Review
Learn about Humana Medicare plan options, including Humana Medicare Advantage plans, Part D Medicare drug plans and Medicare Supplement plans. Find out what these types of Humana insurance plans cover, how much they cost and how you can enroll.
Humana is one of the most popular insurance companies in the U.S., and the popularity of its selection of Medicare plans is no different. In 2021, nearly 1 out of every 5 Medicare Advantage beneficiaries was enrolled in a Humana Medicare Advantage plan.
Humana offers Medicare Advantage (Medicare Part C) plans, Medicare Part D prescription drug plans and Medicare Supplement Insurance (also called Medigap) plans in many parts of the U.S.
Humana has been serving the needs of Medicare beneficiaries for more than 30 years. The company – based in Louisville, KY – provides insurance to more than 20 million Americans, including around 8 million Medicare Advantage and Medicare Part D beneficiaries.1
Humana also supplies customers with group and individual health insurance, Medicaid plans, military insurance and other managed care plans, in addition to life insurance and standalone vision and dental plans.
Humana ranks number 52 on the Fortune 500 list.
91% of Humana Medicare Advantage plan members are enrolled in a plan rated 4 stars or higher by Medicare in 2021.2
A Medicare Advantage plan from Humana delivers all of the same benefits you’ll find in Medicare Part A and Part B. On top of that, many Humana Medicare Advantage plans may offer some additional coverage for things like prescription drugs, dental, vision, hearing, fitness memberships and more.
Humana offers four different types of Medicare Advantage plans. Each one includes coverage for:
- Inpatient hospital stays and emergency transportation
- Lab work, X-rays, screenings and imaging
- Telehealth visits
- Outpatient care and procedures
- Preventive care and specialist visits
- Medical supplies and equipment
Many of Humana’s Medicare Advantage plans also participate in the Insulin Savings Program, also known as the Part D Senior Savings Model, which allows eligible members to pay a maximum copay of $35 per month for their insulin.
Humana Medicare Advantage plans also offer telehealth services for copays as low as $0. This means you can receive some telemedicine services from in-network doctors and specialists for a low cost and without having to go to the doctor’s office.
The selection and cost of Humana Medicare plans may vary by location. While Humana offers each of the following types of Medicare plans, each type of plan may not be available where you live.
Humana HMO Plans
A Health Maintenance Organization (HMO) plan from Humana allows members to enjoy increased savings when visiting a network of participating health care providers. Members will choose a Primary Care Physician (PCP) to help coordinate their care and make referrals for specialist visits.
Humana PPO Plans
Members of Humana’s Preferred Provider Organization (PPO) plans have the choice to save a little bit more money by receiving care within the plan’s network or enjoy a little more freedom to visit the health care providers of their choice and still receive at least some coverage.
There is no need to utilize a Primary Care Physician or obtain referrals to visit specialists. If you visit a provider outside of the preferred provider network, however, you may pay higher out-of-pocket costs for your care than you might if you visit an in-network doctor.
Humana PFFS Plans
Humana offers Private Fee-For-Service (PFFS) plans that allow you to visit any Medicare-approved provider who accepts the terms of the plan. This plan option offers the freedom and flexibility to seek the care you want or take your coverage with you when you travel.
Humana SNP Plans
Humana Special Needs Plans (SNP) are custom built to meet the needs of members with specific health conditions or other qualifying criteria. These plans are ideal for those who need more narrowly-focused coverage to better manage their lifestyle or condition.
Humana SNPs are designed for beneficiaries who:
- Have a certain type of chronic health condition such as diabetes, chronic heart failure or chronic lung disorders or cardiovascular disorders
- Live in a long-term care facility
- Are dual eligible for Medicare and Medicaid
A Medicare Part D plan from Humana provides coverage for prescription drugs, which is something you won’t find in Original Medicare (Medicare Part A and Part B, which don’t typically cover prescription drugs).
Humana Medicare Part D plans are accepted at a wide range of pharmacy networks including Walmart, Costco, Sam’s Club, Kroger, Harris Teeter, Publix and more. All of Humana’s Part D plans include the Insulin Savings Program.
Humana offers several different Part D plans, though plan selection and costs may vary by location.
Humana Walmart Value Rx Plan (PDP)
Humana’s Walmart Value Rx plan is available for a premium of $17.20 per month nationwide and is accepted at more than 9,000 pharmacy locations. Tier 1 and Tier 2 drugs (typically lower cost generic drugs) have a $0 deductible and more than 3,500 drugs are covered under the plan in all five tiers.
This plan may be the best choice for beneficiaries who want to find a Part D plan with affordable monthly premiums and low copays for most generic drugs.
Humana Premier Rx Plan (PDP)
The Humana Premier Rx plan has no deductible (and often no copayment) for Tier 1 and Tier 2 drugs. There are more than 3,700 covered medications on the drug plan formulary, and a 30-day supply of select insulin can come with a copayment of as little as $30.
Monthly premiums can range from $58.30 to $72.50 per month depending on where you live.
These plans might be a good choice for beneficiaries who are looking for the peace of mind that can come with having the most comprehensive Humana Part D plan.
Humana Basic Rx Plan (PDP)
The Humana Basic Rx plan is ideal for those who qualify for the Medicare Extra Help prescription drug cost assistance program, which may cover the entire cost of this plan. The Basic Rx option can come with premiums that range from $19.70 to $45 per month, with more than 3,450 covered drugs, $0 copayments on Tier 1 medications and $1 copayments on Tier 2 drugs.
Humana Medicare Drug Formulary
Humana Part D plans cover thousands of prescription drugs, and the company makes it easy to access those lists of covered drugs, called a Medicare plan formulary.
You can use the online formulary to search for a specific drug or print out the Prescription Drug Guide.
Newsweek awarded Humana as the Best in Customer Service 2020 among health insurance companies.
A Medicare Supplement Insurance (Medigap) plan helps pay for Original Medicare deductibles, copayments, coinsurance and other out-of-pocket expenses found in Part A and Part B.
Medigap plans are standardized nationwide in terms of their coverage, but the selection of available plans and their monthly premium costs will differ from one location to the next.
There are 10 types of standardized Medigap plans available in most states, and Humana offers the following 8 plans, though each type of plan may not be available where you live:
- Plan A covers your Medicare Part A coinsurance, Part B coinsurance/copayments, the first three pints of blood needed for a transfusion and hospice care copayments and coinsurance. Medigap Plan A is not the same as Medicare Part A, which is your hospital insurance coverage and is part of Original Medicare.
- Plan B covers the same benefits found in Plan A and also includes coverage for the Medicare Part A deductible. Medicare Plan B is different from Medicare Part B, which is your medical insurance coverage for outpatient care, doctor’s services and durable medical equipment.
- Plan C includes all of the benefits offered by Plan B in addition to coverage for skilled nursing facility coinsurance, the Medicare Part B deductible and foreign travel emergency care.
Medigap Plan C is no longer available to new Medicare beneficiaries who became eligible for Medicare after January 1, 2020. If you became eligible for Medicare before 2020, you can still apply for Plan C if it’s available where you live.
Medigap Plan C is not the same as Medicare Part C, which is another term for Medicare Advantage plans.
- Plan F is the most comprehensive and most popular Medigap plan and the only one to offer benefits in all 9 coverage areas that a Medigap plan can offer. Plan F coverage includes everything found in Plan C along with coverage for Medicare Part B excess charges. Like Plan C, Plan F is no longer available to new Medicare beneficiaries who became eligible for Medicare after Jan. 1, 2020.
- Plan G includes everything found in Plan F with the exception of the Medicare Part B deductible. Other than Plan F, Medigap Plan G is the most comprehensive type of Medigap plan, and it is the second most popular Medicare Supplement plan available.
- Plan K covers all of the benefits that are covered by Plan B, but it only covers 50% of the costs for Medicare Part B coinsurance/copayments, first three pints of blood, hospice care coinsurance/copayments and Part A deductible being (instead of covering 100% of those costs like Plan B does). Plan K also covers 50% of the cost of skilled nursing facility coinsurance and 100% of your Medicare Part A hospital coinsurance costs.
Plan K includes an annual out-of-pocket spending limit. Once you pay $6,220 for covered costs in 2021, your Medigap plan will cover the rest of your covered costs for the rest of the year.
- Plan L is identical to Plan K, but Plan L covers 75% of these costs, instead of 50%. Plan L also covers 100% of the Medicare Part A coinsurance.
Like Plan K, Plan L includes a yearly out-of-pocket spending limit. After you spend $3,110 on covered services in 2021, Plan L covers the rest of your covered costs through the rest of the year.
- Plan N includes all of the same benefits as Plan G, with the exception of any coverage for Medicare Part B excess charge coverage. With Plan N, you’re required to pay a $20 copay for some doctor’s office visits and a $50 copayment for emergency room visits that do not result in inpatient hospital admission.
You can use the chart below to compare each type of standardized Medicare Supplement plan. Note that Humana may not offer each type of plan where you live.
|Medicare Supplement Benefits||A||B||C1||D||F1||G||K||L||M||N|
|Part A coinsurance and hospital costs||✓||✓||✓||✓||✓||✓||✓||✓||✓||✓|
|Part B coinsurance or copayment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|First 3 pints of blood||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Part A hospice care co-insurance or co-payment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Co-insurance for skilled nursing facility||✓||✓||✓||✓||50%||75%||✓||✓|
|Medicare Part A deductible||✓||✓||✓||✓||✓||50%||75%||50%||✓|
|Medicare Part B deductible||✓||✓|
|Medicare Part B excess charges||✓||✓|
|Foreign travel emergency||80%||80%||80%||80%||80%||80%|
|1. Plans C and F are not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
2. Plans F and G also offer a high deductible plan which has an annual deductible of $2,370 in 2021. Once the annual deductible is met, the plan pays 100% of covered services for the rest of the year. The high deductible Plan F is not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
3. Plan K has an out-of-pocket yearly limit of $6,220 in 2021. Plan L has an out-of-pocket yearly limit of $3,110 in 2021.
4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 for emergency room visits that don’t result in an inpatient admission.
View an image version of this table.
The Centers for Medicare and Medicaid Services (CMS) rates the quality of all Medicare Advantage and Medicare Part D plans every year on a 5-star scale. In 2021, 92% of Humana’s Medicare Advantage members are enrolled in a Humana Medicare plan rated 4 stars or higher.
Humana maintains a strong reputation as a company at large, and some of the independent reviews of Humana Medicare plans include:
- J.D. Power ranked Humana number one in customer satisfaction among mail order pharmacies in 2020.
- Humana maintains an A+ rating with the Better Business Bureau.
- Newsweek awarded Humana as the Best in Customer Service 2020 among health insurance companies.
As a large insurance carrier, Humana has a nationwide reach of health care providers. Specific networks of participating providers will vary according to the plan and location, but members can rest assured they will most likely have plenty of doctors, pharmacies and other health care providers from which to choose when using insurance provided by such a large carrier.
Will My Doctor Accept My Humana Medicare Plan?
Humana makes it easy to find a doctor or other health care provider within a plan’s network.
You can use the Humana Find a doctor tool to locate doctors, dentists, vision care providers and pharmacies near you who are part of a Humana plan network. You can also consider searching for a provider by name using Humana’s searchable provider directory.
Many of Humana’s Medicare Advantage plans cover vision care, and the company also sells standalone vision plans. Because Original Medicare does not typically cover routine vision care or eyeglasses, you may want to consider a Medicare Advantage plan to obtain vision benefits through Medicare.
Humana’s Medicare vision coverage often includes annual vision exams, annual allowances for eyeglasses or contact lenses and potential discounts on laser eye surgery.
Just like vision benefits, Humana includes dental coverage in many of its Medicare Advantage plans. Humana’s Medicare dental benefits can include everything from routine cleanings and X-rays to more advanced procedures like fillings and dentures.
Humana Medicare SilverSneakers
SilverSneakers is a fitness program designed specifically for older adults that is offered at thousands of gyms and community centers nationwide. Most of Humana’s Medicare Advantage members receive a SilverSneakers membership at no additional cost.
You may check for a SilverSneakers class near you by searching by your zip code on the SilverSneakers website.
Humana is one of the largest insurance providers in the country and provides at least one Medicare product in every state in the U.S.
Find out which Humana Medicare plans are available where you live.
If you have a Humana Medicare plan, you can call your plan carrier directly to discuss your plan, such as to check on a claim status, file a claims appeal and more.
Humana also has some additional ways to connect, including a live online chat and a Humana support community along with Humana Neighborhood Centers, which offer special events, programs and activities along with the chance to connect for 1-on-1 assistance with benefit questions.
1 Humana. (Feb. 18, 2021). HUMANA INC. INDEX TO ANNUAL REPORT ON FORM 10-K For the Year Ended December 31, 2020. https://humana.gcs-web.com/financial-information/quarterly-results.
2 Every year, Medicare evaluates plans on a 5-star rating system.