Humana Medicare Advantage

State Availability

Last review date: 09/24/2020

Plan Information

Medicare Advantage plans provide the same benefits as Original Medicare and may include additional benefits such as prescription drug coverage, dental, vision, and wellness resources.

Certain Humana plans also offer caregiver support, mail-delivery pharmacies, local community centers, and SilverSneakers® fitness programs.

Individuals may be eligible for a Humana Medicare Advantage plan if you’re enrolled in Original Medicare, don’t have End-Stage Renal Disease, and live in the service area of a plan.

Medicare Advantage Plans currently offered are HMO, PPO, PFFS, and Special Needs Plans (SNPs). Most plans include Prescription Drug Coverage; Medicare Advantage-Only (Part B Giveback) Plans never include prescription drug coverage. Certain Medicare Advantage Plans that offer no prescription drug coverage can be coupled with a stand-alone Prescription Drug Plan. In some states, Chronic Special Needs Plans (C-SNP) and Dual Eligible Special Needs Plans (DE-SNP) are offered; all SNPs must provide Medicare Prescription Drug coverage.

Humana offers Medicare Advantage health maintenance organization (HMO) plans that include all the benefits of Original Medicare and may include prescription drug coverage and many extras.

• Choice of a primary care physician from within the plan’s provider network.
• Affordable monthly plan premiums; $0 premium on some plans in some areas.
• Prescription drug coverage equal to or better than the standard requirement for a Medicare Part D plan (prescription drug coverage not available with all plans).
• Emergency coverage anywhere in the world.
• Coverage for most annual preventive screenings at no additional cost.
• Hospitalization coverage.
• Membership in the SilverSneakers® fitness program (available on most plans).

Humana’s preferred provider organization (PPO) plans give individuals the freedom to visit any Medicare-approved doctor in or out of provider network who accepts Humana’s plan terms, but they will generally pay a lower cost share when you stay in network.

• Affordable monthly plan premiums.
• In-network home healthcare.
• Coverage for most annual preventive screenings at no cost.
• Optional fitness programs and prescription drug, vision, and dental coverage for additional premiums.
• Prescription drug coverage equal to or better than the standard requirement for a Medicare Part D plan; plans without prescription drug coverage may also be available.
• Emergency coverage when you travel outside the U.S.

With Humana’s flexible PFFS plan, individuals can see almost any Medicare-approved doctor they choose, as long as the provider accepts the Humana Medicare Advantage PFFS Terms and Conditions of Payment. Benefits may include:

• Coverage to see any Medicare-approved doctor or provider who accepts the Humana Medicare. Advantage PFFS Terms and Conditions of Payment.
• Full coverage for most annual preventive screenings.
• Prescription drug coverage on most plans.
• Hospitalization coverage.
• Emergency coverage anywhere in or out of the U.S.

A Special Needs Plan (SNP) is a type of Medicare Advantage plan that combines all the benefits of Original Medicare (Parts A and B) with prescription drug coverage (Part D) but is only available to those individuals who have an additional qualifying condition. For example, individuals who:

• Have a specific chronic health condition.
• Are eligible for both Medicare and Medicaid.
• Are a resident of a long-term care facility.

Many of Humana’s Special Needs plans have an affordable or $0 monthly plan premium.

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