Finance Guide

Reviews of Humana’s Medicare Advantage Plan

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Humana Medicare plans can be found in all 50 states. Humana’s Medicare Advantage can also be found in 84% of the counties. This is more than any other insurance. Humana plans are rated highly for customer satisfaction and quality. The company also offers many additional benefits, including online and mobile apps and ways to interact with them.Pros

  • Available all over the country
  • Plans of high quality
  • Special pricing at Walmart for certain prescription drug plans
  • Humana Pharmacy is the number one pharmacy for mail-order prescriptions

Cons

  • Some Humana plans score poorly for satisfaction
  • Humana may be sold to another company.

Pros Explained

  • Widely available across the country: Humana Medicare Advantage plans are available in more counties than any other insurer, and at least one type of Humana Medicare plan is available in every state plus Puerto Rico.1
  • High-quality plans: 92% of Humana Medicare Advantage members were enrolled in a plan rated 4 stars or higher by CMS, the agency that oversees Medicare.2 J.D. Power also ranked Humana third overall in its 2020 U.S. Medicare Advantage Study.7
  • Special pricing at Walmart for certain Prescription Drug Plans: Humana offers a relatively low-cost Stand-alone Prescription Drug Plan co-branded with Walmart, which gives members lower costs when they get their prescriptions at Walmart locations.
  • Humana Pharmacy is the number one mail-order pharmacy service: Humana Medicare members who have prescription drug coverage and mail-order benefits can use Humana Pharmacy. According to J.D., Humana Pharmacy is the best-rated mail order prescription service. Power.8

The Cons

  • Some Humana plans do not score well for satisfaction: NCQA, the accrediting body, gives Humana plans mixed results, with several subsidiaries scoring poorly on customer satisfaction.3
  • Humana’s ownership could change: Although any company can acquire another, Humana was a target for acquisition in the past. Previous reports indicated that Walmart would buy them.

All Plans Available

Humana offers several Medicare Advantage plan options, with different benefits, costs, and rules.

HMO Plans

Humana’s Medicare Advantage HMO plans typically need a referral from your primary care provider (PCP) to see specialists, but you can switch PCPs if you’re not happy. These plans include the Original Medicare benefits as well as additional benefits. Many HMO plans offered by Humana include SilverSneakers health benefits and prescription drug coverage.

PPO Plans

Humana’s PPO plans allow you to visit any Medicare-approved doctor without a referral, regardless of whether they specifically participate in Humana’s provider network. In-network providers will usually lower your costs. While specific benefits will vary by location, many plans offer home health services and prescription drug coverage. Additional benefits include fitness programs, vision and dental benefits. Humana’s PPO policies also provide coverage for you when you travel to the U.S.

Private fee-for-service plans

Private fee-for-service plans (PFFS) don’t require you to have a PCP, or get referrals to specialists. However, Humana has established a network to ensure that members have access to the best care. In some areas, Humana offers PFFS plans with no preferred provider network, which means members can see any provider who accepts Medicare fee-for-service rates. Humana’s PFFS plan covers most annual preventive screenings and hospitalizations. Most also cover prescription drugs.

Prescription Drug Plans that are Stand-alone

Prescription Drug Plans (PDPs) that are stand-alone do not cover any other benefits or medical coverage. They only cover prescription drugs that fall within the Medicare coverage gap. These plans work alongside Original Medicare Parts A and B. Humana offers three PDP options.

The Humana Walmart Value Rx Plan has the lowest premiums and low copayments on Tier 1 and 2 drugs, but higher-tier drugs cost more and are subject to a deductible. The Humana Premier Rx Plan is the most comprehensive option from Humana, with more than 3,700 covered prescription drugs, though premiums are higher than the other plans. The Humana Basic Rx Plan is designed for people who qualify for Extra Help, a Medicare program to help people with limited income pay for prescriptions; this plan includes free or very low-cost prescriptions.

Medicare Supplement (Medigap) Insurance

Medicare Supplement plans, also known as Medigap, cover some of the costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. There are eight standard plans that cover different costs. Not all of them are available in every state. Medigap plans don’t cover prescriptions, and they cannot be combined with other coverage such as a Medicare Advantage plan.

Medicare Advantage Special Needs Plans

Humana offers two types of Special Needs plans: Dual-eligible Special Needs plans (D-SNP) and Chronic Condition Special Needs plans (C-SNP) for people with at least one chronic condition such as diabetes, cardiovascular disease, chronic heart failure, and/or chronic lung disorders. These plans can be used by people who have Medicare Advantage and Medicaid. C-SNPs or D-SNPs provide all the benefits of Medicare Advantage, as well as additional benefits that are specific to the needs of the member population.

Humana SNP members receive personalized support to manage their conditions. This includes care coordination and other benefits that can be tailored to suit specific needs. Humana SNP plans may offer routine dental, vision and hearing benefits, as well as non-emergency transport, fitness programs and allowances for over-the-counter medications. Many Humana SNP plans offer low or zero monthly premiums.

Transition for those with limited income

Medicare Limited Income Newly Eligible Transition program (LI-NET), provides temporary drug coverage to people who are eligible for Medicare, Medicaid, or Supplemental Security Income. This program covers prescriptions temporarily while the Medicare member enrolls into a Prescription Drug Plan.

Extra Benefits

Many Medicare Advantage plans include additional benefits such as vision, fitness, and dental benefits. These benefits are becoming more common. In 2020, 98% of Medicare Advantage plans also offered telehealth benefits.1

Humana’s Medicare Advantage plans include Dual-eligible special needs plans. They offer vision and dental benefits, an over-the-counter medication allowance and fitness programs.

Humana offers an Insulin Savings program in certain of their Stand-alone Prescription Drug Plans and MAPD plans. The cost of insulin medications is limited to $35 per 30-day supply.

Humana offers Medicare members other wellness programs, including:

  • Go365, a program that rewards members for engaging in healthy behaviors
  • SilverSneakers is a health benefit that offers a variety of programs.
  • Health Foods Cards for Dual-eligible Special needs plan members, so they can purchase healthy food and beverages
  • Humana Well Dine is a meal delivery service for members who are recovering from hospitalizations, or who have a chronic condition.

Humana provides care management services to members with complex medical needs and chronic diseases. Medicare Advantage members may be eligible for Humana At Home services. This personal care manager helps individuals remain at home.

Customer Service

Humana customer service can be reached by calling or by booking an appointment online. Call 800-457-4708 to get assistance with Medicare plans.

Call 888-328-64998 for Special Needs Plans, available between 5 a.m. ET and 8 p.m. EDT, seven days per week.

Members and potential members can access information and complete certain tasks, such as finding forms and paying premiums online. Humana members can chat with customer service and download the MyHumana app, which lets members check coverage and benefit details, view their member ID card, view claims, and find providers.

Humana is available to answer basic Twitter questions seven days a semaine, between 6 a.m. – 8 p.m. Please note that you cannot resolve any personal issues or questions via social media.

Customer satisfaction

The National Association of Insurance Commissioners tracks complaints against all types of insurers, including health insurance. In its complaint index, a score of less than one means the insurer received fewer than expected complaints; a score of greater than one means they received more than expected.

Humana’s overall complaint index was 1.23 in 2020, a decline from 2019 when it was 1.00 and 2018 when it was 2.17.9 Humana’s Medicare Supplement Insurance is way above average.

Ratings from Third Parties

AM Best

AM Best, the credit rating agency that assesses insurance companies’ financial strength, affirmed its A- (Excellent) Financial Strength Rating of Humana and the majority of its health insurance subsidies, effective August 6, 2020.10 An A- rating indicates that the company has an excellent ability to meet its ongoing insurance obligations.

NCQA

The National Committee for Quality Assurance is a top-ranking accreditation body for health plans. It rates them based on quality of care and customer satisfaction. In the 2019-2020 ratings, Humana plans scored between 2 and 4 out of 5.3 These composite scores include customer satisfaction measures, including satisfaction with the consumer’s ability to get needed care, satisfaction with the doctors, and satisfaction with the health plan.

Many Humana plans scored 4 stars on satisfaction with their health plan. This is the best measure of plan customer service and experience. It’s not as direct as physician satisfaction ratings or overall ratings.

J.D. 

J.D. Power measured member satisfaction with Medicare Advantage plans in its 2020 U.S. Medicare Benefit Study. Power measured member satisfaction with Medicare Advantage plans.7 On the overall customer satisfaction index, Humana ranked third overall with a score of 806 points out of 1,000, placing it just above the industry average of 800.

Medicare Star Ratings

CMS rates Medicare Advantage and Prescription Drug Plans with five stars on its quality rating system. These ratings reflect how well plans can help members manage chronic conditions and stay healthy. They also consider how satisfied members are with the service and plan. These ratings include member complaints.

Star Ratings can vary depending on the plan, state and county. In 2020, 92% of Humana’s Medicare Advantage members enrolled in plans rated at least 4 out of 5 stars.2

Cost

Costs for Medicare health plans depend on many factors. These include where you live, what type of coverage you want and which insurance company you choose. The best way to compare specific cost information across insurers in your area is through the plan finder on Medicare.gov, though it helps if you know what type of plan you want. Humana’s website, on the other hand, lets you compare their Medicare Advantage options with and without prescription drug coverage, as well as and Stand-alone Prescription Drug Plans (PDP) in one search.

Monthly premiums are the most important costs to be aware of. Many Medicare Advantage plans have very low or even zero monthly premiums. In 2020, sixty percent of Medicare Advantage Prescription drug Plan enrollees had no premium. The average monthly premium for all Medicare Advantage enrollees (with and without premiums) is expected to be $21.111

Premiums are not the only cost. Medicare Advantage plans can have prescription coverage or not. They may include copayments, coinsurance and deductibles. These additional costs can outweigh any savings you may have on a $0-premium policy.

Prices for a stand-alone prescription drug plan include:

  • Humana Walmart Value Rx Plan: This plan has the lowest monthly premium of Humana’s PDP options ($17.20), with no deductible on Tier 1 and 2 drugs, $1 and $4 copayments for Tier 1 and 2 prescriptions, respectively, at preferred pharmacies ($10 and $20 copayments at nonpreferred pharmacies). Tiers 3, 4, 5 have a $445 copayment and deductible.
  • Humana Premier Rx Plan: Premiums range from $58.30 to $72.50, depending on where you live. Tiers 1 through 2 have no deductible, while Tiers 3 through 5 have a $445 minimum. For Tiers 1 and 2, copayments are $1, $4 and $10 respectively at preferred pharmacies (nonpreferred pharmacies have $5 and $10 copayments). Tiers 1 and 2, however, have no mail-order copayment. Tier 3 drugs have higher copayments, while Tier 4 and 5 have coinsurance.
  • Humana Basic Rx Plan: This plan is best suited for people who qualify for Extra Help, which helps offset medication costs for lower-income people. Depending on where you live, premiums can range from $19.70 up to $45.00. For Tier 1 and Tier 2 drugs, copayments are $1 and $0 at preferred pharmacies, while $2 and $1 respectively at nonpreferred pharmacies. Tiers 1 and 2, however, have no mail-order copayment. Tiers 3, 4 and 5 have coinsurance.

Competition: Humana vs. UnitedHealthcare

Humana and UnitedHealthcare are the Medicare Advantage plans with the broadest geographical coverage; 84% of counties have Humana options, 66% have UnitedHealthcare, and 60% have both.1 UnitedHealthcare is the nation’s largest health insurer, with more than 14% market share.

UnitedHealthcare has an exclusive partnership agreement with AARP. This gives it a distinct advantage as a trusted brand affiliation. UnitedHealthcare’s average Star Rating is slightly higher. Both companies provide multiple customer support channels and online tools. UnitedHealthcare offers members the ability to choose a plan that suits their needs with cost estimators and customized recommendations. The difference in a head to head comparison may be due to differences in quality ratings and costs. These vary depending on where you live.