What is Humana?
Humana is a health insurance company that provides a range of insurance options for individuals, families, and businesses. The company offers Medicare and Medicaid plans, as well as private health insurance plans. It also provides additional services such as prescription drug coverage, vision and dental insurance, and health savings accounts.
Humana is based in Kentucky and is one of the largest Medicare insurance companies, offering health coverage in all 50 States.
What Types of Medicare Plans Does Humana Offer?
Humana offers several different types of Medicare plans, including:
- Medicare Advantage plans: Also known as "Part C" plans, these plans provide an alternative to Original Medicare (Parts A and B) and often include additional benefits such as prescription drug coverage and additional services such as vision and hearing.
- Medicare Prescription Drug plans: Also known as "Part D" plans, these plans provide coverage for prescription drugs not covered by Original Medicare.
- Medicare Supplement plans: Also known as "Medigap" plans, these plans supplement Original Medicare and can help pay for out-of-pocket expenses such as deductibles, copayments, and coinsurance.
- Special Needs Plans (SNP) : These plans are designed for people who have specific chronic conditions such as End-Stage Renal Disease (ESRD) or have specific needs like living in an institution.
- Medicare-Medicaid Plans (MMP) : These plans are for people who are eligible for both Medicare and Medicaid.
It's important to note that the availability of these plans varies depending on location and individual's eligibility.
How Do Humana Medicare Advantage Plans Work?
Humana Medicare Advantage (MA) plans, also known as Medicare Part C, work as an alternative to Original Medicare (Parts A and B). When you enroll in a Humana MA plan, you will receive your Medicare benefits through the plan instead of Original Medicare.
With a Humana MA plan, you will typically have access to additional benefits such as prescription drug coverage, vision and hearing coverage, and in some cases, coverage for additional services like dental and wellness programs.
You will be required to choose a Primary Care Physician (PCP) from the plan’s network of providers and in most cases, you will need to get a referral from your PCP to see a specialist.
With a Humana MA plan, you may have to pay a monthly premium, in addition to any deductibles, copays and coinsurance you have to pay for the services you receive. However, these costs are usually lower than those associated with Original Medicare and Medigap plans.
What Does Humana Medicare Advantage Cover?
Humana Medicare Advantage plans typically cover the same benefits as Original Medicare (Medicare Part A and Part B), as well as additional benefits such as prescription drug coverage, routine vision and dental, and wellness programs. Some plans may also include additional benefits such as hearing aids, gym memberships, and transportation to medical appointments. The specific coverage offered by a Humana Medicare Advantage plan can vary depending on the plan and location.
Do Humana Medicare Plans Require a Referral?
The referral requirements for Humana Medicare plans can vary depending on the specific plan and type of service.
In general, Original Medicare (Medicare Part A and Part B) does not require referrals for most types of care. However, some Medicare Advantage plans, including those offered by Humana, may have different referral requirements than Original Medicare.
For example, some Humana Medicare Advantage plans may require referrals for certain specialists or out-of-network care, while others may not. It is best to check with Humana or the specific plan details to confirm if any referral is needed.
When Can I Change My Humana Medicare Plan?
The time period during which you can change your Humana Medicare plan is known as the Annual Enrollment Period (AEP) or Annual Election Period (AEP). The AEP typically runs from October 15 to December 7 each year. During this time, you can enroll in a new Medicare Advantage plan or switch from one plan to another. If you're currently enrolled in a Medicare Advantage plan and want to switch to Original Medicare, you can do so during the AEP as well.
Additionally, you may also be able to make changes to your coverage during certain special enrollment periods (SEP) if you meet certain criteria, such as moving to a new area, losing employer coverage, or certain life changes.
Additional Resources
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Last updated: January 23, 2023