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Humana was founded in 1961 as a nursing home company under the name Extendicare, and in less than a decade was the largest nursing home brand in the country. In 1972, the company sold its nursing homes to focus on hospitals, changing the name to Humana in 1974. Through growth and acquisitions, Humana became the world’s largest hospital company in its first 20 years.
Humana created its first health insurance plan in 1984, and continued growth and acquisitions through the following decade. By the mid-2000s the company was active in the Medicare market, but faced criticism in 2009. AARP accused the company of sending out deceptive fliers about its Medicare plans, resulting in an investigation by the U.S. Dept. of Health and Human Services. The company was asked to suspend the mailings, but no action was taken against Humana.
In 2016, Humana and Aetna announced a merger that would create a powerful insurance company servicing a variety of markets, including the private Medicare market. The merger has been challenged in court and is pending a decision at the time of this review, but will certainly have a major impact on the health insurance world should it happen.
Humana Medicare Products
Humana sells a full range of Medicare plans. This includes Medicare Advantage, Part D drug coverage, and Medicare Supplement plans. The available plans differ from state to state, but you can easily enter a zip code on the website to obtain a clear run-down of what is available to you.
Because the available plans and rates differ across states, and there is no central list of available plans without entering a specific zip code, we did a search for plans in two zip codes. In both New York and California, Humana offers two different Medicare Advantage plans.
The two plans are both Humana’s Gold Plus HMO coverage, with one offering more coverage than the other – at an increased premium
Humana’s basic Gold Plus HMO basic plan is a zero deductible plan that covers all of what is covered under Original Medicare. In California, this plan is available with no added premium based on the flat rate paid to the company by the government. The New York plan does include a premium, which indicates that the cost of the plan will vary by state. In addition to prescription drug coverage, the plan also includes vision coverage, fitness coverage, transportation, and hearing services.
The next level of the Gold Plus HMO plan adds additional coverage such as dental services. This plan does have a deductible for both medical services, as well as drug coverage.
Both options have a $0 co-pay for office visits, whether they are primary care or specialist. The basic plan has a lower out of pocket maximum but offers less added coverage. The Humana site is very user friendly and allows you to compare the plans that are available side-by-side.
Other states may have additional coverage options and the plan details may vary.
Part D (Prescription Drug Coverage)
In both states we reviewed, Humana offers three Part D plans for prescription drug coverage.
The most affordable plan is the Humana Walmart Rx Plan. This plan is something like an HMO for drugs, as cost sharing on prescription drugs is only available at Walmart, Sam’s Club, and Walmart Neighborhood Market pharmacies. This keeps the cost down but does limit those enrolled to obtaining their prescriptions in particular locations. Although, in some cases mail-order is also available. The plan has a $400 deductible with no deductible on Tier 1 and 2 drugs. Co-pays for drugs start at $1.
The Humana Preferred Plan is a step higher in terms of coverage and has a higher premium. There some confusion as to what the deductible is, as one section states $360 and another states $400. Again, the lowest co-pays are available from Walmart branded pharmacies with $0 co-pay for mail-order from Humana’s own pharmacy.
The Humana Enhanced Plan is the highest level of coverage. There is no deductible for this plan and co-pays are as low as $0. There is no indication that this plan has any connection with Walmart or any other branded pharmacy, but it also comes with the highest premium.
Medicare Supplement Plans
Humana offers a range of Supplement plans that are designed to cover what isn’t provided for under Medicare. Our sample states showed a list of 8 different such plans in California, but no such coverage in New York. As with all other health plans, available coverage differs depending on where you live.
In California Humana offers the basic Plan A as well as B, C, F, high-deductible Plan F, K, L, and N. That’s a good range of plan options to choose from, each adding additional coverage options. The selection allows customers to choose the options that they need without paying for anything they don’t. For example, someone who never travels outside the U.S. won’t need to pay for Foreign Travel Emergency coverage.
Some plans have a $0 deductible, but most have a $166 deductible. The High-Deductible Plan F is the exception with a $2,180 deductible. These plans are usually designed to offer a lower premium cost in return for the insured person paying more out of pocket on deductibles when the coverage is needed.
Rates for Coverage
Humana’s two Medicare Advantage plans are priced very well. The Basic plan in California has a $0 premium, as the company receives money from the government for it. This is common with Advantage plans, although it’s not available from every company or in every state. The same plan did have a $24.10 per month premium in New York.
The second plan we quoted in California has a monthly premium of $16.50 per month and includes extra coverage over the basic plan. This plan also costs more in New York.
Based on other plans we have quoted with the same California zip code, Human’s rates are quite reasonable. That said, it would require a very careful comparison of coverage, deductibles, and rates for an individual in order to be entirely clear on which option has the best price.
Humana’s Part D coverage is also reasonably priced, starting at $17 per month for the most basic plan. Of course, it’s worth noting that the plan is connected with a particular line of pharmacies, so that lower rate does come with some restrictions. Humana’s highest level of prescription coverage still comes in with a lower premium than similar plans elsewhere.
Ratings and Reviews
There are 801 reviews of Humana on Consumer Affairs. Of those, 173 left a starred review, resulting in an overall one-star rating for the company. Only one review was a five-star review. Since Humana is so big in the Medicare industry, there are a number of reviews that pertain directly to the Medicare plan coverage. There are multiple complaints about difficulty finding in-network providers, as well as a large number of complaints about customers feeling they were getting the run-around from the customer service department. As with most insurance companies, there are many complaints about denied claims. Many of those go on to say they had a difficult time getting assistance with an explanation for the denial.
Humana has an A+ rating with the Better Business Bureau (BBB). In the past three years, there have been 484 complaints filed against them. 131 of those were closed in the past 12 months. Those numbers aren’t out of line for a company the size of Humana.
Overall, there are quite a few complaints regarding Humana, and many of them do pertain to Medicare. The numbers aren’t incredibly high, but the repeated complaints citing similar issues in such numbers is a cause for some thought.
Humana is currently awaiting a final court decision on the merger with Aetna, which could very well change their policy offerings and rates. The uncertainty for the company’s future makes it difficult to recommend them solidly as a Medicare provider. That said, they do have some of the best rates we have seen for their policies and that is bound to carry a lot of weight for those shopping around for a new Medicare plan. If you are willing to take a risk on where the chips land after the merger court date in return for a good price on your coverage, you may want to include Humana on your list.
For a list of companies that we recommend, visit our Best Insurance Companies page.