Humana Medicare Advantage Review
Humana's commitment to providing enrollees with extra perks, earns them a spot in our top 3 picks. Along with extra benefits, Humana offers asy online tools for managing coverage, claims, and records.
- Wide variety of plans
- Numerous wellness benefits and incentive programs
- Chronic disease management programs
- Most plans include drug coverage
- Honor plan tailored for military veterans
- Mail-order pharmacy available
- Lower than average customer service scores
- Limited pharmacy options
- PPO and PFFS plans may not offer many more benefits than HMO
What you need to know about Humana Medicare Advantage plans
Humana is the second-largest provider of Medicare Advantage plans in the United States. With four million members, representing roughly 18 percent of all beneficiaries who choose Advantage plans, Humana is a well-known, well-respected insurer with a history of quality service.
The company is known for providing a wide range of options to suit a variety of different needs within their plans and doing so within an affordable price range.
What kind of quality can you expect from Humana?
Eighteen of Humana's Medicare Advantage plans received a four-star or higher rating from Medicare in 2020, signifying above-average quality. Six of those plans garnered a four-and-a-half star or higher rating, which comes close to Medicare's top rating of five stars for excellence.
Humana's customers enjoy simple and convenient online tools for managing claims, understanding coverage, and obtaining records. However, customer satisfaction scores tend to be lower than average for a company of this size, with customers citing slow and ineffective customer service as a primary concern.
Who recommends Humana?
Humana has received the following accolades and endorsements:
Ranked #1 insurance company for customer service by Newsweek.
Accredited by the Better Business Bureau (BBB) and holds an A+ rating
Included in Forbes magazine's "The Just 100: America's Best Corporate Citizens"
Named top mail order pharmacy for customer satisfaction by J. D. Power in 2018
Obtained rating of A- by A.M. Best for financial strength
Numerous accolades for diversity in the workplace and inclusion of military veterans
How does Humana Medicare Advantage insurance work?
You may choose to receive your benefits from the federal government through Medicare Part A and Part B (Original Medicare), or you may choose to receive your benefits through a Medicare-approved, private insurance company like Humana.
The plans offered by Humana as an alternative to Original Medicare are known as Medicare Advantage plans, or Medicare Part C. All Advantage plans through Humana are required to offer at a minimum the same coverage as Original Medicare, but they can also include more coverage and extra benefits.
You may choose a Medicare Advantage plan during your Initial Enrollment Period, which starts three months before and ends three months after your 65th birthday. You have the option each year during the Open Enrollment Period to opt for an Advantage plan instead of Original Medicare or switch to a different Advantage plan.
Advantage plans differ from Original Medicare by restricting you to a local network of providers, but they often provide an affordable way to get more benefits and extra perks.
What Medicare Advantage Plans does Humana offer?
While each plan will vary somewhat depending on where you live, we'll highlight some of the defining qualities of Humana's most popular plans.
Humana Gold Plus (HMO)
By far Humana's most popular offering, this HMO plan offers low or $0 monthly premiums, low or $0 medication premiums, no deductibles, a very low specialist copay and limited hearing, vision, and dental coverage. The maximum out-of-pocket costs for in-network care is close to half of what you may pay with other insurers. You are restricted to in-network providers only, and you may be required to obtain referrals or preauthorization for certain services.
Bottom line: A practical, budget-friendly plan that offers good coverage and plenty of extras without breaking the bank.
This plan affords you more choices about which providers you see. In-network options will be cheaper, but you still have the choice to go out-of-network. Regional plans vary, but you still likely will have the option to get low or $0 monthly premiums. Your copays will be higher than the HMO plan, and you'll have a higher out-of-pocket yearly maximum as well as a drug deductible. Your vision and dental services may still be limited, and in some areas the plan excludes vision and dental coverage entirely.
Bottom line: A good choice if you have a preferred provider who is not covered under the HMO plan. Otherwise, probably not worth the added cost since there aren't many extra benefits beyond what the HMO offers.
Humana Gold Choice (PFFS)
The PFFS plan is similar to a PPO in its ability to offer greater choice in providers at a higher price point. You'll pay a higher monthly premium ($116 per month in the plan we sampled), drug deductibles, and a higher out-of-pocket maximum. Vision and dental coverage is still limited; in the plans we sampled, some offer no dental coverage or no vision coverage, but hearing services are usually covered.
Bottom line: This plan is similar to the PPO, but higher in price with some services not covered. If both the PPO and PFFS are offered in your area, the PPO may be a better choice.
How do Humana Medicare Advantage plans compare to other insurance providers?
Compared to other providers, Humana's HMO plans offer more perks and extra benefits while still maintaining affordability. With such low out-of-pocket costs while still offering perks, it's easy to see why Humana's Gold Plus HMO plan is preferred by so many people.
However, Humana's PPO and PFFS plans don't offer much more value outside of the option to go out-of-network. These plans don't stand out as favorably against the competitors.
What makes Humana Medicare plans stand out from the rest?
It's the all-around value of the HMO plans, which include a variety of extras, that set Humana apart.
How does pricing work with Humana, and can I get any discounts?
If you choose an HMO plan, you likely will not need to pay a monthly premium. You still will be responsible for the standard Part B premium, which is true for any Advantage plan, no matter which insurance carrier you choose.
Each plan varies in the amount you'll pay for deductibles, copays, and yearly out-of-pocket maximums, but generally the HMO plans will cost less than the PPO or PFFS plans.
Humana offers a variety of health and wellness discounts as well as vision and hearing discount programs.
How do I know if I am eligible and can enroll in a Humana Medicare Advantage plan?
If you're eligible for Medicare Parts A and B, you are eligible to enroll in any Advantage plan available in your area. You may choose to forgo Original Medicare and enroll in an Advantage plan when you're first eligible for Medicare, or you may choose to enroll or switch plans each year during the Open Enrollment Period.
Best for free extra benefits
Humana's HMO plans offer perks and extra benefits.
Health and wellness discounts
Humana's Savings Center provides links for members looking for health and wellness discounts.
Humana offers access to a 24-hour nurseline.
By: Courtney Schmidt
Courtney Schmidt is a medical communications professional and clinical pharmacist with pediatric and adult hospital experience.