Humana Health Insurance Pros and Cons in 2022

By | May 14, 2022

Humana Health Insurance Pros and Cons in 2022

Humana Medicare programs are available in all 50 states, and Humana’s Medicare Advantage is available in 84% of regions, more than any other insurance. Many Humana programs have positive results in quality and customer satisfaction, and the company offers a solid set of additional benefits and ways to communicate with them, from online skills to a mobile operating system.

Humana Health Insurance Pros

  • Available nationwide: Humana Medicare Advantage programs are available in more states than any other insurance, and at least one type of Humana Medicare plan is available in all states and Puerto Rico.1
  • High quality programs: 97% of Humana Medicare Advantage members are enrolled in a 4 star rating system or higher by CMS, which oversees Medicare.2 J.D. Power also ranked Humana fourth overall in 2021 U.S. Medicare Advantage Study.3
  • Walmart special prices for specific prescription drug programs: Humana offers a low-cost Stand-alone Prescription Drug Plan integrated with Walmart, offering members a lower cost when receiving their prescriptions at Walmart locations.
  • Humana Pharmacy is the first number of e-mail orders: All Humana Medicare members who have prescription drugs with the benefits of e-mail can use Humana Pharmacy, a high-quality email order service, according to J.D. Power.4

Humana Health Insurance Cons

  • Some Humana programs do not get enough satisfaction: NCQA, the credit bureau, provides Humana programs with mixed results, with several sub-companies earning low points in customer satisfaction.5
  • Humana’s ownership could change: Any company could be acquired, but Humana has been a target for acquisition in the past, and previous reports suggested that Walmart would buy them.

Available Programs

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

HMO programs

Humana’s Medicare Advantage HMO programs often need to be referred to your primary care provider (PCP) for specialists, but you can change PCPs if you are not happy. These plans include Original Medicare benefits and additional benefits. Most Humana HMO programs incorporate the durable benefits of SilverSneakers, and many include prescription over-the-counter medications.

PPO programs

Humana PPO programs allow you to visit any Medicare-authorized doctor without referral, regardless of whether you participate directly in the Humana provider network. Your costs will usually be lower if you visit healthcare providers within the network. Certain benefits vary from place to place, but most of these programs include home-based health services, access to prescription drugs, and additional benefits such as fitness, vision, and dental programs. Humana’s PPO programs also cover you when you travel outside the U.S.

Confidential billing plans

In a private fee-for-service (PFFS) program, you do not usually need to have a PCP or referral to see specialists, but Humana is establishing a network of providers to ensure members can access the care they need.

Elsewhere, Humana offers PFFS programs outside the preferred provider network, meaning members can see any provider who accepts Medicare-for-service rates. Humana’s PFFS programs include annual prevention screening, hospitalization, and emergency care and emergency care; most also cover prescription drugs.

Default Drug Programs Only

Stand-alone Prescription Drug Plans (PDP) includes medications that fall into the Medicare injection space but do not provide any medical implants or other benefits. These plans operate alongside Original Medicare Parts A and B. Humana offers three PDP options.

The Humana Walmart Value Rx Plan has very low premiums and low fees for Phase 1 and 2 drugs, but high-quality drugs are more expensive and less expensive. Humana Premier Rx Plan is the most comprehensive option from Humana, with over 3,700 prescription drugs, although the premiums are higher than other programs. Humana Basic Rx Plan is designed for people who qualify for Additional Assistance, a Medicare program to help people with a low income pay for orders; This program includes free or low-cost instructions.

Medicare Supplement (Medigap) Insurance

Medicare Supplement plans, also known as Medigap, cover some of the costs that Original Medicare excludes, such as payments, coinsurance, and deductibles. There are eight standard plans that cover different costs; not all are available in all regions. Medigap plans do not include prescriptions and cannot be combined with other inserts such as the Medicare Advantage program.

Medicare Advantage Special Needs Plans

Humana offers two types of Special Needs Programs: Two Special Needs Programs (D-SNP) and Chronic Needs Care (C-SNP) programs for people with at least one chronic condition such as diabetes, cardiovascular disease, chronic heart failure, or disease. chronic lung.

These programs are Medicare Advantage programs for people with Medicare and Medicaid. C-SNPs and D-SNPs offer all Medicare Advantage benefits as well as additional benefits tailored to the needs of individual members of private insurance who may choose to include them.

Members of the Humana SNP receive personal support to help manage their circumstances, such as contact care or other additional benefits to meet the specific needs of members. Some Humana SNP programs offer general dental, visual, and hearing benefits, non-emergency transportation, fitness programs, and over-the-counter medications.

Many Humana SNP programs have low or no monthly premiums.

New Appropriate Changes in Limited Income

The Medicare Limited Income Newly Eligible Transition (LI-NET) program provides temporary drug coverage to people who are eligible for a Medicare subsidy, also called Additional Assistance, and who are eligible for Medicare and Medicaid or Supplemental Security Income. The plan includes instructions temporarily until a Medicare member registers on the Prescription Medication Program.

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