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Humana Medicare Review

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Eric Stauffer is a former insurance agent and banker turned consumer advocate. His priority is to help educate individuals and families about the different types of insurance they need, and assist them in finding the best...

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UPDATED: Nov 30, 2018

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As one of the biggest healthcare companies in the nation, Humana covers millions of people and is a major player in Medicare as well. They offer a full range of Medicare products including Advantage, Part D, and Supplement options across the nation.

About Humana

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.

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Humana Medicare Products

Humana covers all of the Medicare basics, offering Advantage plans as well as Part D prescription drug plans and Medicare supplement.

Medicare Advantage

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.

Part D

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.

Medicare Supplement

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.

Rates

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.

Claims

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.

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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.

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Review Information

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About Eric Stauffer

Author: Eric StaufferI am a former insurance agent and banker turned consumer advocate. My priority is to help educate individuals and families about the different types of insurance they need, and assist them in finding the best place to get it.

22 Comments

  1. Humana must be being run by a children’s play group – the customer service is total useless and not fit for purpose.

    I covered myself with a dental plan in December 2019. In February 2020 I added my children to the policy – I was told the total premium would be $58.96 ($22.99 my original premium plus $28.98 for the children) and I was charged the quoted premium the first month.

    The following month I was charged $72.97 – no one notified me of the change. I called and spoke to Cawane in their customer service department – I was informed I had the wrong premium, but the billing on my account proves I was quoted and charged incorrectly. I want to be charged what I was told!

    Cawane told me he would listen to the taped conversation and call me back by the end of the week – of course nothing.

    I emailed and called and was told the issue was going to reviewed and I would receive a call back – again nothing.

    One the 4th June I reluctantly spoke to Kemoi in there customer service department – I was told the policy was cancelled and I would no longer be charged. Everything was taken care of. I found insurance elsewhere at roughly the price Humana quoted in February.

    On the 24th June, Humana charged me again!

    I will copy and paste this review on every website possible.

    Very unhappy customer!

    Reply
  2. Humana Prescription D Plan just doubled my monthly premium rate without notifying me.

    They will now not let me change to a less expensive plan.

    I may just have to drop my part D drug coverage. Humana is useless.

    Medicare for All would be the best so that even seniors are not taken advantage of by these for-profit insurance companies.

    Humana is the worst. Please vote for Bernie Sanders.

    Reply
  3. Welcome to private insurance. It’s a for-profit enterprise.

    that means the way they make a profit is by denying your claim.

    the more claims they deny the more profit they make, the more health care they pay for the less profit they make.

    we have to eliminate the private insurance companies. Medicare for all.

    Reply
    • I totally agree! I have a friend who has Humana Insurance and she lives half the year in Indiana and spends the winters in Florida.

      Heaven forbid she get sick in Indiana because Humana will NOT pay her bill!!!!

      Now, who needs insurance like that? It’s useless.

      One never knows when they are going to get sick or where they might be when they do become ill, but we have found that if she just happens to be up here in Indiana and needs to go to the doctor or get medicine, forget Humana!

      They are not at all there to pay her doctor bill…..ONLY IF SHE GETS SICK IN FLORIDA!!!!

      This is the worst insurance company I’ve ever heard of! It seems to be useless and she pays for it!!!!!!!!

      No wonder these big insurance companies like Humana are making tons of money!

      If you don’t pay the client’s claims, of course you’re going to get rich!

      What a rip off! I wouldn’t have Humana if they were the last insurance company on earth.

      She happens to be on Medicare, too, and it would probably do to just have it rather than add a Humana policy on with it because that seems to be where the problem is.

      Reply
  4. I was diagnosed with a neurogenic bladder five years ago and although I was seeing a urologist,

    He had a catheter supplier send me those single-use catheters to help with my retention issue;

    now, about a month ago, I received a notice from Humana informing me my claim was denied and they are no longer paying my supplier for my catheters;

    WTH!!? This was never an issue for the past five years, so why all of a sudden it’s become one now?

    I may need to appeal and get a letter from my urologist for backup; this isn’t right!!

    Reply
  5. I just signed up, so don’t have experiences yet. But in the process of selecting insurance, I learned this:

    HMO Organizations not only require the provider to follow the rules/laws for which they earned their license, they have extra rules required by the HMO. It limits what they can do (stated by an IHC Nurse Practitioner)

    I have had two providers at Intermountain Healthcare. If you go to their providers, PLEASE, follow through by getting copies of the notes the provider reported for your appointment. I am going through a nightmare at this time because of a provider who didn’t pay attention to details; assumed, jumped to conclusions and reported such to Disability. NOW, I have sent for an addendum to the three appointments I’ve had with one provider. The notes in files are legal documents and can not be changed. Addendums are required and can take up to 60 days to be added to a file, if approved. Another provided was told I had a doctor for 21 years (stand alone, PPO) who needed to read my secondary thyroid readings. After he closed his practice, I had a hard time finding an MD who could read secondary. They wanted to lower my dose based on my TSH reading, when my Free T3 and Free T4 were optimum. Instead of sending me to an endocrinologist, they wanted to treat themselves. No referral. I wasn’t reducing my dose, so paid out of pocket to see a Naturopathic Doctor. The doctor who wanted to reduce my dose, only recorded other doctors told me my meds needed to be reduced and I disagreed. Those other three doctors were over two years. They disagreed with what my doctor of 21 years TRAINED ME to know about my readings. Thank God he did.

    I also saw an MD at another facility. I was accused of wanting to use medication to lose weight. I was GAINING two pounds a week and had multiple hypo symptoms. By the time I found someone who knew about secondary readings, I’d gained 40 pounds.

    SO, I am now signed up with Humana to start in February 2019, I will be seeing a DO who is their plan, who knows how to read secondary readings and his preferred medication is the one I’m taking and have done the best on it. Levothyroxine, Synthroid, Armour and NP all result in a 97 temp for me, raised cholesterol, that leads to fatty liver. Nature-Throid my temp came up to 98.5 and I stabilized (liked the lower LDL, raised HDL and NO fatty liver). Yes, because the company who makes it changed out their machines and are heavily back ordered, it’s hard to get it. 9/11/2018 I was able to get 6 months. In 7 weeks my temp of 97 rose to 98.4.

    May God bless me, I will never have to go to an HMO organization again.

    A broker told me: There are two things for which people select Humana PPO – Acupuncture as part of their Silver Sneakers and NO referrals needed to see a specialist. Perhaps it is wise to make sure the specialist is part of their network and will be covered, BEFORE seeing them.

    Reply
    • humana is far worse than any hmo

      Reply
  6. Humana Medicare Advantage from a provider point of view is a nightmare. There will be no less that 40 minutes on the phone just trying to get a prior authorization. If you need to speak to a nurse reviewer, it will be even longer. I have waited over an hour to speak to someone- this is for one patient! I was transferred to another line for imaging and the entire message was in Spanish! This has happened more than once.
    The staff are courteous but often difficult to understand, which causes an even greater delay. I feel sorry for patients who choose this plan – everything will need a prior authorization! Serious delay in care.

    Reply
  7. I am interested in getting dental and vision coverage only, any responses to this coverage to share, anything I should be aware of before making getting this?

    Reply
  8. I just signed up for Humana Medicare. Was this a big mistake

    Reply
    • If you picked a basic plan, YES.

      Humana is like a telemarketing company who will harass you via telephone.

      Just received a phone call today and they told me if I don’t listen to what they have to offer, they will continue to call.

      I know they are trying to get more money from me to pay for their long boring commercials.

      Hope you have a better experience. Told them not to bother me, I will call them if I need them.

      Close to canceling, to be honest. All about the money.

      Reply
  9. I strongly recommend Don’t purchase Humana Health Care.

    Reply
    • I totally agree. Having had Humana this year I am more aware than ever how diabolic it would be to have single payer. We have to never let that happen. If we think having been turned down and Rx’s so high you can’t afford them one can only dread if we had no other choices. Humana thinks they are God and do not care one bit about who is trying to take care of their patients. A nightmare comes true.

      Reply
      • You’re confused. All private insurance is a ripoff. What we all want is single payer (Medicare) health insurance. we must eliminate the profiteering private insurance companies. The right-wing media has convinced Americans to vote against their own best interests.

        Reply
  10. I am disabled and recently been advised by Medicare that I am now on Medicare part A and part B. So have been researching many different options available to me also researching reviews of different now, i do not know if I can believe anything these representatives /sales personnel tell me. So what can a person believe? I am seriously confused what to do and now it is apparent that Trump will cut many millions from Medicaid which obviously will be felt by all Medicare recipients in the form of denied claims. Any advise is appreciated Thanks

    Reply
    • Hi David,

      First – Medicare and Medicaid are two different programs. Its easy to confuse the two, and a lot of people do.

      Second – If you are having trouble getting through all the marketing material and commercial bombardment to get to the real detail, you are not alone. Its a very lucrative industry, so there is a lot of sales pressure out there. Finding a local insurance broker can often be a great solution. If you have a car insurance agent, start there. If they don’t work in the health field, they can often refer you to either a broker or individual that helps people customize Medicare Supplement plans.

      Best,
      Eric Stauffer

      Reply
  11. Customer service is DISGUSTING!!! They’re computer is down so they have their customer service representative pretending to be automated services repeating some B.S. line. When I realized that it was another human being on the other line and said something but the representative kept on repeating the same stupid script. When I asked for a supervisor he hung up. Called back two more times and was hung up on again. It is completely understandable the the systems are down but I would rather the representative acknowledge me and say that instead of insulting my intelligence and pretending to be an automated service repeating a “prerecorded message” . DISGUSTING! Not only did I not get the issue that I have resolved, now I am upset. POOR customer service. Can’t wait for their system to be back up so I can give them a piece of my mind

    Reply
  12. I do not recommend Humana for Medicare people. They search every way possible to not pay the claim. I will be soooo glad to get rid of them at the end of this year.

    Reply
    • Every private insurance company tries in every way possible to deny your claim. That’s why the free market doesn’t work for health care. Only a single payer system can work fairly. The free market is motivated by profit. They don’t want to pay for health care. The more claims they deny the more profit they make. This is common sense. The more health care they pay for the less profit they make.

      Reply
  13. My husband is diagnosed with Lewey Body Dementia, and fell a week ago. He does not have the strength to lift himself up. We have a bed at a rehab available, and have been waiting a week for Humana Medicare to approve it. My husband Is still in the hospital, and I’m taking leave w/out pay waiting for their approval to get him into rehab!

    Reply
  14. My sister was recently discharged from a hospital in Houston Tx Memorial weekend, with a blood clot in her lung secondary to lung cancer. She was discharged with out a discharge plan, without her blood thinner preauthorized. She has been without her blood thinner even after the Dr called and spoke with Humana. They assured the Dr the auth would go thru. After repeated attempts to pick up the medication at the pharmacy, was told the auth did not go thru. She has been out of the hospital now for 14 days with out her blood thinner medication. We also found out Humana has also denied her for other cares as well. She has now decided to just give up and wants to die, cause no one seems to care!

    Reply
  15. Humana’ Part D coverage is a joke and a product I recommend no one purchase. While our agent researched their formulary against our current medications, once we made the mistake of buying coverage, their denials began to arrive. Appeals were a joke/waste of time hence we now must personally purchase two longstanding effect meds.
    If anyone, or their agent, is looking for Part D coverage, I strongly recommend they don’t purchase it from Humana! I can’t wait for renewal time when we can dump this mediocre coverage with a company who, I believe, defines customer service as maximized corporate profits.

    Reply

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