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The Various Coverage Plans and Options Offered By Humana Health Care. Humana Medicare Plans Broken Down and Compared in 2019

Getting health insurance is not just about the coverage, it’s also about the reputation of the insurance provider. Getting support from the insurance provider at the time you need them for when the unexpected happens is vital. Humana is one of the top choices for health insurance when offered as a health insurance benefit by employers, large corporations, and organizations to individuals belonging to them.

With such a large customer base, almost every hospital, doctor’s office, and clinic accept Humana, avoiding any out-of-provider network headaches that lead to additional costs or lack of coverage. They offer discount dental plans and healthcare through Medicare, also covering things like doctor visits, specialist, tests, and blood work. Plans can vary regarding what they cover and how much it will be, but overall it covers a wide range of services.

What Humana Offers

Humana offers various health insurance products to provide a wide range of health coverage to individuals. These products can be offered to cater towards a variety of needs of any individual, senior citizen, business, or organization to offer optimal, quality health insurance. Humana is particularly known for offering quality health insurance options while working with government health provisions nationwide to offer suitable health insurance at a lower cost. This avoids many complications one may face with a smaller health insurance provider or government assisted plan from the health insurance marketplace. Humana plans, can offer coverage to a wide range of doctors, providers, and cover most prescription medication.

Humana Options For An Individual

If you are an individual that is under 65 years of age and not accepting Medicaid. Humana can be a good choice for purchasing health insurance privately. You can get coverage for just yourself or your entire family with optimal coverage for a wide range of Medical & health-related services. You can choose from a wide range of health providers, potentially even your doctor of choice and likely have coverage of necessary prescription medications. In addition to general health insurance, Humana also offers both dental and vision insurance options. When combined with general health insurance, you may qualify for even greater discounts on dental and vision coverage making your dental and vision services virtually free. Humana also offers health insurance plans through the Health Insurance Marketplace where individuals can apply for cost assistance. By applying for health insurance through the marketplace, Humana may present options to you as low of a cost compared to purchasing an insurance policy outside of the marketplace.

Humana Options Through Your Employer

As noted above, Humana is a top choice among organizations and businesses who offer health insurance as a benefit. Humana insurance offers the same benefits as it would for an individual buying insurance from Humana on their own. However, the individual’s employer or organization can pick what is and is not offered at their discretion. In circumstances where Humana is offered by the employer, the cost can be reduced without having to apply for cost assistance through the Health Insurance Marketplace.

Humana Options Through Medicaid

Currently, Humana also offers free or low-cost health care to individuals who accept Medicaid. This provision is currently only available in 2 states, that is Florida or Illinois. Since Medicaid is a state-operated program, the state has the ability to determine what is available and what is not available to those who accept Medicaid. Humana is a great provider of health insurance since it is a major insurance provider, this is highly beneficial to individuals or families that accept Medicaid as it can offer better health coverage options, a wider network of provider offerings, and offer a broader range of cover as opposed to individually state offered Medicaid options. Related image

Humana Options Through Medicare

One of the biggest provisions offered by Humana is their affordable health insurance options through Medicare. Humana is one of the largest providers of health insurance that works in conjunction with Medicare for seniors over 65 years old. Known as their Medicare Advantage plans, Humana provides coverage for all parts of Medicare including Medicare Part D for prescription drugs, dental, and vision care all from one provider. Humana’s Medicare Advantage plans are among the best in the industry, coming with the many perks in addition to their outstanding coverage and network of providers. The advantage plans come in 3 unique options. For example, the basic HMO Gold plus plan alone offers $0 co-pay and give’s individuals a realistic understanding of how their out of pocket expenses will be. While their top of the line plan, the HMO Gold Plus plan offers the most flexibility offered in a health insurance plan with a low monthly premium and the flexibility to choose almost any doctor you prefer.

Discounted Dental & Vision Care Through Humana

For those looking solely for dental and/or vision care, Humana can offer both dental and vision care without requiring the purchase of general health insurance coverage. Both individual Dental and Vision care plans are low cost for both monthly premiums and out of pocket expenses. But you may want to consider a discount dental plan instead. The discount dental plans can be used as much as is needed. This is unlike dental insurance, which only provides payment up to a certain amount, usually about $1000. Discount dental plans offer money off each service. So, if you have five cavities and need fillings for all of them, the discount plan might give you 50% off each filling. Conversely, dental insurance may max out and not cover all the fillings. And dental plans can cover root canals and crowns, which cost much more than the maximum benefit price of an insurance plan. Discount plans usually have no waiting period, no copay’s, no deductibles, and they even offer discounts on orthodontics.

The Various Coverage Plans and Options Offered By Humana Health Care

Humana health care is also a provision that ensures people who are on Medicare. This includes older adults over 64 and disabled adults under the age of 65. It works like an HMO and is called an Advantage plan. Medicare will only cover 80% of covered services and require a 20% coinsurance that needs to be paid. Plans, like Humana, will pick up the majority of the cost, charging only a co-payment (in most cases) for services. But, you must make sure you read and understand everything that is included, or excluded from, the plan you are looking at. Some plans might have a lower copay, but do not include prescriptions. This is a critical aspect to understand because if your plan does not come with prescription coverage, you may need to buy a separate plan (like you have to do with Medicare).


Humana Gold Plus Health Maintenance Organization (HMO) demands that the subscriber use a network of providers and requires referrals for specialists. They will not pay for services that are done out of network. However, even though you have to stick with your network, there are many providers to choose from. One drawback to having an HMO Advantage plan, like Humana, is that they will probably require a referral. A referral is when a specialist needs approval from your primary doctor to render services. Additionally, testing facilities might need prior authorization. This is usually required when more expensive testing and services, like an MRI, is requested. The insurance company wants to make sure the test or service is warranted and is needed to properly care for the patient. Getting a referral might mean having to see your primary doctor before going to a specialist or having a test done. However, they have plans that do not require a monthly fee. The plans can vary state to state, so it is important to research your own state to find out which plans are available.


Humana Choice Preferred Provider Network (PPO) allows you to use any doctors, regardless of whether they are in or out of network. So, if the doctor takes your insurance but is not in the provider network of your area, you can still see them, you will probably just have to pay higher co-payments and maybe even a coinsurance. Humana will pay more when you use the in-network providers because they have contracts with them that dictate how much they will be paid based on the service that you need. Importantly, you do not need referrals.


Humana Gold Choice Private Fee-For-Service (PFFS) plans let you use anyone who is Medicare approved and who accepts the plan’s conditions and terms. In essence, this plan does not have a network that subscribers are held to and providers are not required to see people with this plan. So, if the provider refuses the contract with Humana, they do not have to treat you. This plan will still pay for hospital stays, annual screening and comes with a prescription plan.


There are usually co-payments for services with Humana, but they are generally less than the 20% coinsurance that Medicare demands. This is important when referring to the disabled and the elderly. Most times, this population is living on a fixed budget and medical expenses can get costly. Humana helps by keeping the out of pocket costs lower. Additionally, Humana care plans are accepted by a significant amount of doctors, hospitals, and testing facilities. But, as with making any change to your insurance, you need to make sure your doctors take the insurance. There is nothing worse than getting a big bill in the mail for services you thought were covered under your insurance.

What If I Have Medicare Part B?

Even though you still have to pay your Medicare Part B premium, you may be able to find health care plans that will not require an additional monthly fee. The choices between the plans will dictate whether you have to pay another monthly fee on top of the Part B premium. And plans that require an additional fee for the plan will have different deductibles, copay’s, and the difference in what is covered. You can find extensive research online, which will let you put in your location. When you put your zip code in, you will be able to see which health care plans are available in your area, what they cost, and what they cover. So, research is key. Additionally, there are organizations that you can speak to in order to get clarity of coverage and cost.