Humana Medicare Advantage Plans and What They Cover


Humana is a nonprofit health insurance company based in Kentucky and approved by Medicare to sell Part C plans. Humana offers options for HMO, PPO, PFFS, and SNP plans. If you’ve already decided to take a Medicare Advantage (Medicare Part C) plan, you still have some decisions to make. One is the insurance company that provides your coverage. In 2020, Newsweek ranked Humana first of all health insurers in customer service for the second year in a row.


Is humana a medicare advantage plan?

Options for Humana Medicare Advantage Plan – Humana’s PPO Plans

Humana Medicare advantage plans are divided into several sections. Preferred Provider Organization (PPO) plans give you the freedom to choose any Medicare-approved doctor you want to see.

Humana HMO Plans

The Health Maintenance Organization (HMO) plans are attractive to many people because of their affordable prices. By law, these plans require at least as much as the original Medicare, so you can rest assured that you’ll get coverage for hospitalization, medical coverage, and preventive care, including annual checkups and vaccinations.

As with any HMO, you must select your doctors, including your primary care physician (PCP), from the plan’s network of providers. Humana offers a Service Points Plan (HMO-POS) that allows you to select providers outside the network under certain circumstances.

Humana’s HMO covers emergency medical care outside the United States. Some Humana HMOs also include prescription drug coverage that is equal to or better than Medicare’s individual Part D plans. Most of these plans include a free membership to many local gyms and health clubs. Not all fitness facilities are included in this list.

Humana’s PFFS Plans

Private Fee for Service (PFFS) plans are not available in all areas. With a PFFS plan, you can see any Medicare-approved doctor, as long as they’ve accepted Humana’s PFFS terms of use and payment.

Humana PFFS plans are different from the original Medicare plans and other supplemental plans. As an insurance company, Humana, not Medicare, determines how much healthcare professionals and hospitals pay and how much you should pay for your care.

  • With a PFFS plan, you don’t have to choose a primary care physician.
  • Prescription drugs are included in most, but not all, PFFS plans.
  • Emergency aid outside the United States is covered.

It is very important to confirm that your doctor has an ongoing agreement with the Humana PFFS network before receiving any services. Unless you need emergency care, there is no guarantee that the doctor you see will treat you or accept payment from your plan.


Humana SNPs

Special Needs Plans (SNPs) are usually free and require no deductibles, premiums, or coinsurance. SNPs are only available if you meet specific criteria, for example:

  • Eligible for Medicare and Medicaid
  • With a Medicare-approved chronic disability condition for an SNP


Humana offers two types of SNPs available in approximately 22 states. The second type is for people with certain chronic health conditions, for example:

  • end stage renal disease (ESRD)
  • chronic lung disease
  • cardiovascular disease
  • chronic heart disease
  • diabetes mellitus

If you qualify for a Humana SNP, you will receive all of your original Medicare benefits plus Medicare Part D. Health and wellness programs may also be included for conditions such as diabetes and preventive treatment. Your SNP may also include regular dental care, eye care, hearing care, and non-emergency medical transportation.


Humana Part D

These Part D plans are used to control the cost of prescription drugs.


Walmart Value Rx Human Plan

Under the Walmart Value Rx Humana Plan, Humana joins Walmart, Walmart Neighborhood Markets and Sam’s Club Pharmacies as preferred cost-sharing partners.

This allows Humana to provide additional prescription savings to people who purchase their medications from Walmart.

Before choosing the Humana Walmart Value Rx plan, make sure you live near a Walmart store that offers pharmacy services. While you can use other pharmacies under this plan, you will not receive additional discounts if you do not use Humana’s preferred cost-sharing partners.


Premier Rx Human Plan

Like the Walmart Value Rx plan, the Humana Premier Rx plan also uses Walmart as its preferred cost-sharing partner. This means that living near a Walmart location is the key to saving the most on income.

While this plan has a higher premium than the Walmart Value Rx plan (from $58 to $73 per month, depending on your state or region), the Humana Premier Rx plan has additional benefits.


Basic Human Rx Plan

Unlike Humana’s Part D second plans, the Humana Basic Rx plan allows you to choose a pharmacy while on the plan’s network.

Humana Basic Rx Plan premiums range from $19 to $46 per month, depending on your state or region. Humana’s Medicare supplemental insurance, also known as Medigap, can help you pay for expenses that Medicare Part A and B don’t cover. These costs include things such as co-insurance, personal contribution and personal contribution.

What can be very different, however, is the company you join. This can affect the quality of service and the price of the subscription. Be sure to compare Medicare advantage plans deals with competing insurance companies to get the best price and coverage for you. Once you’re on a plan, you can find out your details by logging into the MyHumana app.


Which States Offer Humana Medicare Advantage Plans?

Humana offers Medicare Advantage plans in 49 states. Medicare Advantage plans are not currently sold in Alaska. While there is wide availability across the country, specific types of plans and coverage options may only be offered in certain areas.



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