UPDATED: Nov 30, 2018
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Humana was founded in 1961 as a nursing home company called Extendicare. In 1968 it ranked as the largest such company in the nation. By 1972 the company had dropped the nursing home business and started purchasing hospitals, moving towards future status as the nation’s biggest owner of hospitals. The 1974 name change to Humana was part of an effort to change public perception of the company to one that put people first.
During the 1980s Humana started offering its own health insurance plans, and by 1993 had sold off most of its hospital operations to move more heavily into the managed health care market. 2006 saw the company start a major push into Medicare Advantage, with a mass mailing campaign that led to a 2009 government investigation of some of the claims made in these mailings.
In spite of the controversy, Humana’s share of the Medicare industry has grown to put them at the head of the pack. A 2015 merger attempt with Aetna that would have made the combined company a giant in Medicare was shot down by the courts in 2017.
Humana partners with Walmart to place Medicare Part D agents in their stores and provide prescription assistance, and in 2018 announced a partnership with Walgreens pharmacies that will create a primary care network in stores that is focused on senior care.
Humana is headquartered in Louisville, Kentucky and ranked at number 56 on the Fortune 500 list for 2018. Fortune also ranked the company at number 2 in its industry on the list of the World’s Best and Most Admired Companies for 2018.
Humana Medicare Products
Humana covers all of the Medicare basics, offering Advantage plans as well as Part D prescription drug plans and Medicare supplement.
Humana offers three types of Medicare Advantage Plan: one is an HMO, one a PPO, and the last a more unusual PFFS (Private Fee For Service) plan. Plan availability and details vary from state to state; we checked out plans in our usual sample area in Southern California.
The Human Gold Plus HMO plan is an HMO plan using a managed care system. Coverage is only available in-network, which generally makes these plans more affordable. Our sample area search turned up two versions of the Gold Plus plan. In our sample area only these HMO plans were offered, and no PPO or PFFS plans.
The first Gold Plus plan is a zero-deductible plan that features no copays for either primary care or specialist visits, and no hospital copay either. This plan includes prescription drug coverage without a deductible, and also includes dental and vision coverage, as well as hearing.
The second has a $183 deductible for medical and a $405 deductible for prescriptions. Copays are again $0 for primary care and specialist visits, but hospital care is $480 a day for the first three days, $0 thereafter.
The first plan is a $0 premium plan (meaning there is no additional cost above the regular Medicare Parts A & B premiums. The second has a small monthly fee. There is not an explanation as to why the plan that has higher out of pocket costs has a higher premium, but this is usually related to the available network of care.
Our sample returned three results for Part D plan offerings.
The first is a part of Humana’s Walmart partnership and is the least expensive choice. Copays are as low as $1 for Tier 1 drugs when they are purchased from a Walmart, Sam’s Club, or Walmart Neighborhood Market pharmacy. The plan has an annual $405 deductible, but this does not apply to Tiers one and two.
The next plan, Preferred, also partners with Walmart, but copays can be as little as $0 at those pharmacies, as well as from Humana’s mail-order pharmacy. Again, this plan has a $405 deductible, but it appears to apply to all Tiers.
Finally, the Enhanced plan has the highest premium but no deductible at all. There appear to be no limitations on which pharmacy the insured can select. The $0 copay for mail-order still applies to this plan.
In our test area, Humana offers a good selection of the letter-coded standardized Medicare Supplement plans.
Like all companies, they start with Plan A, which is the base plan that pays all of your Medicare coinsurance amounts as well as covering the first three pints of blood each year.
Beyond that they also offer Plans B, C, F (including the high deductible option), L, K, and N. While there are more standard plans available elsewhere, this is a pretty good range of choices that includes Plan F; F covers all out of pocket costs with the high deductible option making it more affordable while helping to make health care costs predictable.
Humana makes it easy to find their rates, displaying them right next to the plan overview as part of the comparison.
For Medicare Advantage, we already noted that one plan has does not have an additional premium beyond the base Medicare premium. The second plan came in at $16.30 a month for our sample area.
The three available Part D plans start at $20.40 a month for the base plan and increase up to $82.80 a month for the most expensive, no deductible plan.
The quoting system requires a little more information for Supplement rates; we quoted a 65-year-old non-smoking female.
The Plan A rate came back at $166.18 a month, Plan F at $228.85 a month. With the high deductible option, Plan F came back at a much more affordable $59.47 a month.
Overall, we found Humana’s rates for our sample to be mainly reasonable and even on the low side. The exception to this is the Supplement rates; both Plans A and F were much higher than what we have seen elsewhere. That said, the high deductible Plan F rate was lower than most other places, so the value in Humana’s Supplement coverage really depends on the plan.
While most claims are handled directly with the provider, Humana does offer claims forms on the website for download in the rare situation that they might be needed. There is also a toll-free customer service number offered that is available for assistance with any claim difficulty. That number is found on the member card.
Ratings and Consumer Reviews
Humana has an A+ rating with the Better Business Bureau (BBB), where they have been accredited since 1998 and have a total of 292 complaints in the past three years, 73 of which were closed in the past 12 months. For a company as big as Humana, this is a very low volume of complaints; bear in mind that this record is for all of their business including individual health care and not only for Medicare.
Complaint volume is a bit higher at Consumer Affairs, where there are 1033 reviews of this company for an overall two-star rating; that rating is based on 135 reviews in the past year. There are a few positive ratings but they are mostly negative, which is not uncommon for a company like Humana. As with most health insurance companies, denied claims make up the bulk of the complaints about Humana. While this is a much higher number than the BBB record, it is still not out of line for such an enormous company – it also goes back more than three years.
It is always hard to separate the Medicare branch of a health care insurer from their other products when it comes to reviews, although a few of the reviews we saw did pertain to Medicare coverage. For the most part, the complaints are similar to those with every health insurance company, and we did not come across any red flags.
The Bottom Line
Humana offers mainly managed care HMO programs, which may not appeal to everyone. They do have some very affordable Medicare plans, at least in our sample area, and that low cost is partially due to the limited network. For those who do not mind an HMO, as well as for those who don’t mind using specific pharmacies, these plans are a pretty good value.
For a list of companies that we recommend, visit our Best Insurance Companies page.