Humana Health Insurance Review, Claims and Payments

As a Humana health insurance or Medicare client, you get extra benefits and ways to interact with them. Beyond traditional Medicare coverage, only Humana gives you Prescription Advantage, which helps manage costs of prescriptions covered by Medicare, Pep to help you pay for out-of-pocket medical expenses, and a health coach service that provides one-on-one support.

Baked-in quality and convenience features help Humana stand out in the Medicare market. The company’s Medicare Advantage plans score well for quality and customer satisfaction, and the company offers a robust set of extra benefits and ways to interact with them, including 24/7 nurse hotline services.

Humana offers individual and family Medicare health insurance plans in all 50 states, plus Washington, D.C., and plans in Puerto Rico. Humana Medicare Advantage is available in 84% of counties in the U.S., more than any other Medicare Advantage plan for individuals. All Humana plans offer benefits to help you stay active, healthy, and engaged.

About the Humana Health Insurance-

If you love to use your smartphone, tablet, or computer to research information, shop, and communicate with other people and businesses, then you’re going to love Humana insurance. They do offer some of the best coverage plans around for Medicare Part D as well, making them a good choice for all types of people.

Medicare Entitlements has partnered with Humana for over 25 years to provide the best Medicare supplemental insurance product in the USA. Your relationship with them has earned them many quality awards since then including the prestigious customer service award. With Humana health insurance, you can select from one of their leading Medicare Advantage plans that offer robust features and benefits, including a wide array of in-network providers at no additional cost, low copays and deductibles, low coinsurance, and much more.

Humana can help you navigate coverage options and compare plans side by side. You’ll find a range of plans, including Medicare Advantage and Part D. You can access the Humana Member Portal to see personalized news, offers, discounts, and more. With the MyHumana app, there are times when you can speak directly with a Humana representative.

The Humana MediBlue TrueBlue is a great option for seniors who want to supplement the Medicare benefits they already have and are looking for an affordable insurance plan. With comprehensive coverage, financial support, and an accessible customer service department, this plan could be a good fit.

Top Alternative for Humana Health Insurance: Blue Shield of California Health

What are the Pros and Cons of Humana Insurance company?

Pros of Humana Health Insurance Explained:

  • Easily accessible throughout the country: Humana Medicare Advantage plans are accessible in much more provinces than just about any other insurer, and each state, and furthermore Puerto Rico, has at least one type of Humana Medicare plan.
  • High-quality plans: According to CMS, which supervises Medicare, 97 percent of Humana Healthcare Insurance representatives were enrolled in a plan rated 4 stars or higher. Humana was also ranked fourth overall by J.D. Power in its 2021 U.S. Medicare Advantage Study.
  • Humana provides a relatively low-cost Stand-alone Prescription Drug Plan co-branded with Walmart, that also provides members lower prices once they fill their prescriptions at Walmart places.
  • Humana Pharmacy is the leader in mail-order prescriptions: According to J.D. Power, all Humana Medicare members who have drug prescription coverage with mail-order advantages can just use Humana Pharmacy, the top-rated mail-order prescription assistance.

Explained Cons of Humana Health Insurance:

Some Humana plans are unsatisfactory in terms of customer satisfaction: Humana plans receive mixed reviews from NCQA, the accredited certification body, with many subsidiary companies scoring poorly on client satisfaction.

Humana’s ownership structure may change: Any company can be acquired, but Humana has previously been rumored to be a target for acquisition, with previous reports claiming Walmart would buy them.

Also Read: How to Activate myCigna your one-stop-shop to view your benefits & view claims

What are the Functional Plans of Humana Health Insurance?

There are multiple available plans for Humana health insurance. We have mentioned them all below for your reference.

PPO Plans-

Humana’s PPO plans let you see any Medicare-approved doctor without a reference, irrespective of whether or not they are part of Humana’s network of providers. When you visit in-network health care providers, your prices will usually be lower. Benefits vary by location, but many of these plans offer home health care, prescription drug coverage, and other benefits like fitness programs, vision, and dental. Also, a thing to note is  Humana’s PPO policy covers you even if you go outside of the United States.

HMO Plans-

To see a specialist, Humana’s Medicare Advantage HMO plans normally require a reference from your primary care provider (PCP), but you can change PCPs if you’re unsatisfied. The plans include Original Medicare benefits as well as additional benefits. SilverSneakers exercise benefits are included in most Humana HMO plans, and many also offer prescription medicine coverage.

Stand-alone prescription drug plans-

Stand-alone Prescription Drug Plans (PDP) cover prescriptions that aren’t covered by Medicare, but they don’t include any medical coverage or other benefits. These plans work in conjunction with Parts A and B of Original Medicare. Humana has three PDP plans to choose from.

On Tier 1 and 2 prescriptions, the Humana Walmart Value Rx Plan has the lowest premiums and copayments, but higher-tier drugs are more expensive and require a deductible. The Humana Premier Rx Plan is Humana’s one of the most extensive choice, with over 3,700 prescription medications covered, albeit premiums are greater than the other plans. The Humana Basic Rx Plan is for persons who qualify for Extra Help, a Medicare program that helps low-income people pay for prescription drugs, which covers almost free or very low-cost prescriptions.

Private fee for service plans-

You’re not required to have a PCP or get referrals to see specialists if you have a private fee-for-service (PFFS) plan, however, Humana maintains a network of providers to guarantee members have access to the treatment they require.

Humana offers PFFS plans without a preferred provider network in select areas, allowing members to see any physician who accepts Medicare fee-for-service rates. Most yearly preventive screenings, hospitalization, emergency, urgent care, and prescription medicines are covered by Humana’s PFFS plans.

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Medicare Supplement Insurance-

Medicare Supplement plans, commonly known as Medigap plans, pay for copayments, coinsurance, and deductibles that aren’t covered by Original Medicare. About eight standardized plans are there that cover various expenditures; however, not all of them are offered in all states. Prescriptions are not covered by Medigap plans, and they cannot be coupled with other Medicare coverage, such as a Medicare Advantage plan.

The following Humana Medigap plans are available, though availability varies by state:

  • Parts A and B coinsurance or copayments, as well as the Part A deductible
  • Coinsurance and deductibles for Parts A and B, as well as skilled nursing facility coinsurance and foreign travel emergency coverage.
  • Everything in Medigap C is supplemented, plus any excess expenses from Part B.
  • Coinsurance, deductibles, and excess costs for Parts A and B, as well as skilled nursing facility coinsurance and foreign travel emergency coverage.
  • Part A coinsurance or copayments (100%) and Part A hospice coinsurance or copayment and deductible are supplemented by Part B coinsurance or copayments and skilled nursing facility coinsurance or copayments (50 percent )
  • Part A coinsurance or copayments (100%) and Part A hospice coinsurance or copayment and deductible are supplemented by Part B coinsurance or copayments and skilled nursing facility coinsurance or copayments (75 percent )
  • Parts A and B coinsurance, as well as Part A deductibles, are supplemented, as are skilled care facility coinsurance and international travel emergency coverage.

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Know about the Medicare advantage special needs plan:

For persons with at least one chronic illness such as diabetes, cardiovascular disease, chronic heart failure, or chronic lung problems, Humana offers two types of Special Needs plans: Dual-eligible Special Needs plans (D-SNP) and Chronic Condition Special Needs plans (C-SNP).

For persons who have both Medicare and Medicaid, these plans are Medicare Advantage plans. C-SNPs and D-SNPs provide all of the Medicare Advantage benefits as well as extra benefits tailored to the requirements of specific member populations that the private insurer may choose to incorporate.

Members of the Humana SNP receive individualized support to help them manage their diseases, such as care coordination or other supplementary benefits tailored to their specific requirements. Routine dental, vision, and hearing services, non-emergency transportation, exercise programs, and over-the-counter drug allowances are all included in several Humana SNP plans. Many Humana SNP plans include minimal monthly premiums or none at all.

Limited Income Newly Eligible Transition-

The Medicare Limited Income Newly Eligible Transition (LI-NET) program provides brief medication cover to persons who qualify for Medicare low-income subsidies, often known as Extra Help, as well as Medicare, Medicaid, or Supplemental Security Income. Prescriptions are covered temporarily until the Medicare member is enlisted in a Prescription Drug Plan.

Explore Some Extra Benefits-

Several of the Medicare Advantage plans include additional benefits such as fitness, dental, and eye care, as well as hearing aids, over-the-counter drugs, and meal plans. These advantages are becoming more widespread. By 2022, 95 percent of Medicare Advantage plans will include telehealth services.

Many Humana Medicare Advantage plans, including Dual-Eligible Special, Needs plans, including dental and vision benefits, an over-the-counter prescription allowance, fitness programs, and home-delivered meals following a hospital stay.

Also, Humana has an Insulin Savings Program in several of their MAPD and stand-alone Prescription Drug Plans. The cost of diabetes drugs is capped at $35 for a 30-day supply of specific insulins under this scheme.

Other wellness initiatives available to Humana Medicare members include:

  • Go365 is a program that pays users for participating in healthy behaviors.
  • SilverSneakers is a fitness benefit that offers a variety of programs.
  • Dual-eligible Special Needs plan participants can use Healthy Meals Cards to purchase nutritious foods and beverages.
  • Also to note that Humana Well Dine is a meal delivery service for members who have been hospitalized or are being treated with a chronic condition.

Customer Service of Humana Health insurance for hospitality-

Please keep in mind that Humana’s customer service can be reached by phone or by submitting an online appointment request. At 800-457-4708, you can get help with Medicare plans seven days a week from 8 a.m. to 8 p.m. ET.

Call 888-328-6498 between 5 a.m. and 8 p.m. ET, seven days a week, for Special Needs plans.

Members and potential members can access information and complete some duties, such as locating forms or paying premiums, over the internet. Members of Humana can contact customer support or download the MyHumana app, which allows them to verify coverage and benefit details, access their member ID card, examine claims, and locate providers.

Humana promises to answer simple queries on Twitter between the hours of 6 a.m. and 8 p.m., seven days a week. However, you cannot address personal questions or difficulties via social media to preserve your privacy.

Also, check out our trending guide to Login To Therap Service To Arrange Medical Records

What is the Cost service of Humana Health insurance?

The cost of a Medicare health plan is determined by a number of variables, such as where you reside, the type of coverage you choose, and the insurance carrier you select. The plan finder on is the best tool to compare exact cost information across insurers in your area, and it helps if you know what type of plan you want. On the other side, Humana’s website allows you to compare Medicare Advantage plans both with or without prescription drug coverage, and also Stand-alone Prescription Drug Plans (PDP) in one lookup.

The most obvious expenditures to consider are monthly premiums, although many Medicare Advantage plans have low or no rates. In 2021, nearly two-thirds of Medicare Advantage Prescription Drug Plan members paid no premium, and the average monthly premium for all Medicare Advantage enrollees, including those who paid premiums and those who did not, is $19 in 2022. 

However, Premiums do not give the complete picture of how much something costs. Copayments, coinsurance, and deductibles may be included in Medicare Advantage plans, both with and without pharmaceutical coverage. Other expenses may offset any savings you could get from a $0-premium plan.

Wrapping up

Humana is a leading provider of Medicare plans. From extra benefits to customer satisfaction, they believe that quality care is just as important as quantity care. Humana’s Medicare plans are available in all 50 states and the company offers a robust set of extra benefits and ways to interact with them, from online capabilities to a mobile app. So, that was all in our post and we hope you liked it!

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