Humana is an insurance company founded in 1961 that offers a wide range of health insurance plans primarily in the United States. The company has over 11 million customers and had over 39 billion in revenue in 2012. Alongside Medicare insurance products, Humana also sells individual and family, dental, and vision health insurance plans. Humana’s health insurance plans are offered both on public (federally-facilitated and state) as well as private exchanges.
Medicare Insurance Products from Humana
Humana offers several distinct Medicare-related insurance products:
Medicare Advantage – Medicare Advantage plans are also called Medicare Part C. Medicare Advantage covers original Medicare (Part A & B) with additional benefits such as wellness programs. Medicare Part A covers hospital or nursing facility costs as well as hospice and home healthcare. Medicare Part B covers doctor’s visits and outpatient care as well as some preventive services. It also covers services Part A excludes such as certain occupational and physical therapy services. HealthPocket conducted a study which found 97% of Medicare Advantage plans offered at least one vision, dental, or hearing benefit, with vision benefits being the most common additional benefit.
Humana offers the following types of Medicare Advantage Plans1:
- Humana Gold Plus® (HMO) – This plan requires the choice of a primary care physician within the plan’s healthcare provider network
- HumanaChoice® (PPO) – This plan offers the choice of any doctor or hospital (most plans) but enrollees pay less if they receive healthcare in-network. The plan offers referral-free visits to any doctor that accepts Medicare
- Humana Gold Choice® (PFFS) – This plan offers the choice of almost any doctor that accepts Medicare
- Humana Medicare Advantage Special Needs Plans (SNP) – These plans offer benefits, providers, and drug formularies that are specially designed to meet the needs of enrollees (e.g. suffering from chronic diseases such as diabetes or those who are dually eligible for Medicare and Medicaid) often use this plan
Medicare Part D prescription drug plans (PDP) – Original Medicare (Part A & B) does not cover prescription drugs. Humana offer stand-alone drug plans providing prescription drug coverage. See the formulary of the prescription drug plan to review which drugs are covered and at what cost-sharing level.
Medicare Supplement (Medigap) – Supplement plans also known as Medigap plans are purchased to help cover out-of-pocket costs not covered by Medicare Part A & B. There are 10 standard Medigap plan types in 47 states (Massachusetts, Minnesota, and Wisconsin have unique plan designs) though Humana does not offer all Medigap plans in all states. Prescription drug coverage is not included in Medigap plans.2
- Optional supplementary benefits – Humana offers OSB to members of certain Humana Medicare Advantage plans. Those who qualify may enroll throughout the year and benefits pay change January 1st of each year. Humana offers the following OSBs3:
- MyOption Dental - High PPO – 100% coverage in-network (70% out-of-network) routine care, $1,500 maximum annual benefit
- MyOption Enhanced Dental PPO – 100% coverage in-network (50% out-of-network) routine care, $1,500 maximum annual benefit, basic procedures and major services partially covered
- MyOption Enhanced Dental HMO – 100% coverage in-network routine care, $1,500 maximum annual benefit, basic procedures and major services partially covered
- MyOption Vision – Coverage to help pay for routine vision exams, discounts on glasses and contacts
- MyOption Plus – Coverage for both dental and vision, $50 deductible, $1,000 maximum annual benefit, choice of in- or out-of-network dentists
- MyOption Platinum Dental – 100% coverage in-network (50% out-of-network) routine care, no deductible, $2,000 maximum annual benefit, major services partially covered
- MyOption Fitness Well-being – SilverSneakers® Fitness Program membership, up to four phone health guidance sessions
Pharmacy – Humana offers a mail order pharmacy program called RightSource® that bring prescriptions to the residence of members. RightSource® allows you to fill prescriptions three months at a time, speak directly to a pharmacist, possibly save money with 90-day pricing, and each new prescription is reviewed by a pharmacist.