Humana Medicare Advantage 2022 Review

Humana is the second-largest provider of Medicare Advantage plans [1], and the provider that’s available to the most people, with plans offered in more than eight out of 10 U.S. counties. The vast majority of its Medicare Advantage customers are in high-quality plans rated 4 stars or higher by the Centers for Medicare & Medicaid Services, and the company offers some nice perks with many plans.

Although most of Humana’s Medicare beneficiaries are in high-rated plans, some contracts get lower scores than others, so it’s worth doing your research before you sign on.

Here’s what you should know about Humana Medicare Advantage.

Humana Medicare Advantage pros and cons

Humana’s offerings have advantages and disadvantages:

Pros

Most widely available: With plans available in 2,737 U.S. counties (more than 85% of total counties), Humana is an option for more Americans than any other provider.
Quality plans: Humana has 32 contracts rated 4 stars or higher (out of 5) for 2022 that include 97% of its existing Medicare Advantage members. Four 2022 contracts received 5 stars.
COVID-19 perks: Humana offers $0 copays for COVID-19 testing and vaccinations, and for members with a COVID-19 diagnosis, there’s a $0 copay for treatment along with 14 days of home-delivered meals.
Access to a top-rated mail-order pharmacy: Ordering your regular prescriptions for mail delivery can save money, and Humana Pharmacy tops the list in customer satisfaction for the fourth year in a row, according to J.D. Power [2].

Cons

Special needs plans aren’t available everywhere: Currently, Humana’s Dual-Eligible SNPs are available in 30 U.S. states, and the company’s Chronic Condition SNPs are available in only 15 states [3].
Mixed reviews: Humana ranks fourth-highest in J.D. Power’s 2021 Medicare Advantage member satisfaction survey, and the National Committee for Quality Assurance gives several Humana plans a 3 or below out of 5 on its ratings scale.

» MORE: Best Medicare Advantage plans in 2022

Available Humana Medicare Advantage plans

Humana offers several kinds of Medicare Advantage plans, and they vary in terms of structure, costs and benefits available. Many plans offer dental and vision benefits, worldwide emergency care, and fitness benefits through SilverSneakers.

In general, Humana offers Medicare Advantage Prescription Drug plans, or MAPDs, as well as stand-alone prescription drug plans and Medicare Advantage Plans without drug coverage. It’s also worth noting that Humana Honor, the company’s Medicare Advantage plan that’s aimed toward U.S. military veterans, has been expanded into 47 states in its third year of operation.

Other plan offerings include the following types:

HMO plans

A health maintenance organization generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor in order to see a specialist, and out-of-network benefits are usually very limited.

PPO plans

Preferred provider organization plans provide the most freedom, allowing you to see any provider that accepts the insurance. You may not need to choose a primary doctor, and you don’t need referrals to see specialists. You can seek out-of-network care, although it may cost more than seeing an in-network doctor.

PFFS plans

Humana’s private fee-for-service plans allow you to see any Medicare-approved provider who accepts your Humana plan. You won’t have to pick a primary doctor, and you won’t need a referral to see a specialist.

SNPs

Special needs plans restrict membership to people with certain diseases or characteristics. Hence, the benefits, network and drug formularies are tailored to the needs of those members. Humana offers two types of SNPs:

Chronic Condition SNP: For people with one or more of these conditions:
- Diabetes mellitus.
- Cardiovascular disorders.
- Chronic heart failure.
- Chronic lung disorders.
Dual-Eligible SNP: For people who are entitled to Medicare and who also qualify for assistance from a state Medicaid program.

Available Part D prescription drug plans

While many of Humana’s Medicare Advantage plans include Medicare Part D drug coverage, the company also sells stand-alone Part D prescription drug plans. These plans, which are meant to accompany Medicare Part A and Medicare Part B, don't provide medical coverage.

Humana offers three stand-alone prescription drug plans in 2022, with monthly premiums that range from $22.70 to $86.20.

Humana Walmart Value Rx Plan: Average monthly premium of $22.77, costs as low as $0 copay and $0 deductible on Tier 1 and Tier 2 drugs, and access to a wide network of pharmacies, including (but not limited to) Walmart.
Humana Premier Rx Plan: Average monthly premium of $76.65, costs as low as $0 copay and $0 deductible on Tier 1 and Tier 2 drugs, and a broad network of pharmacies.
Humana Basic Rx Plan: Average monthly premium of $35.60, prescription deductible of $480 on all tiers. This plan is aimed at members who qualify for Extra Help, who may be able to get the full cost of premiums covered. Extra Help is a Medicare program that offers assistance to people with limited income and resources.

Additional benefits

Humana Medicare Advantage offers most members access to routine vision, dental and hearing coverage. Many of its plans offer other benefits as well. Here are a few standouts:

Fitness benefits: Most plans include SilverSneakers, which gives you access to participating gyms, community centers, online fitness classes, healthy living discounts and a fitness app, among other things.
Humana Well Dine: If you’re recovering from an inpatient stay at a hospital or skilled nursing facility, or you’re enrolled in a qualified chronic condition SNP, you can receive home delivery of a certain number of meals.
Insulin Savings Program: More than 400 of Humana’s Medicare Advantage Prescription Drug plans offer this, as well as Humana’s Premier Rx stand-alone PDP. This benefit helps eligible members pay less for diabetes medications.
Healthy Foods Card: Almost all members of Humana’s Dual-Eligible Special Needs Plans, or D-SNPs, have access to a Healthy Foods Card, which provides members a monthly allowance of $35 to $100 to purchase approved healthy food and beverages.
Over-the-counter allowance: Some plan members may get an allowance they can put toward over-the-counter items like cough and cold meds, first-aid supplies, vitamins and pain relievers.
Telehealth: All Medicare Advantage members get $0 telehealth copays for visits with a primary care doctor, urgent care and outpatient behavioral health.
COVID-19 perks: Humana members can take advantage of $0 copays for COVID-19 testing and vaccinations, and for members with a COVID-19 diagnosis, there’s a $0 copay for treatment and 14 days of home-delivered meals.
Humana Flex Card: Members of some Florida plans have access to a $250 Visa debit card that can be used to pay for costs related to dental, vision and hearing services and/or devices.

Customer service

Humana members can contact their plan’s customer service in the following ways:

Call 800-457-4708 (TTY: 711), which is available Monday to Friday from 8 a.m. to 8 p.m. in your local time zone.
Online chat.
Contact Humana Help through Twitter.
Dig for answers in the Humana Support Community.

Humana Medicare Advantage service area

Humana offers Medicare Advantage plans in 47 states and Puerto Rico, and Medicare prescription drug plans in all 50 states, Washington, D.C., and Puerto Rico. Humana Medicare Advantage plans are available in 85% of U.S. counties — the most of any provider.

For the 2022 plan year, Humana expanded its HMO offerings into 115 new counties and introduced local PPO plans in 162 new counties. The company also expanded D-SNPs into 268 new counties [4].

Overall, Humana is the second-largest health insurer among for-profit health plans [5]. Nearly 4.9 million Medicare beneficiaries are enrolled in a Humana Medicare Advantage plan.

Cost

Costs for Medicare Advantage plans will depend on your plan, your geographic location and your health needs. One of the costs to consider is the plan’s premium, and in 2022, about half (51%) of Humana’s Medicare Advantage plans have a $0 premium.

For 2022 Medicare Advantage plans with a premium, the monthly consolidated premium (including Part C and Part D) ranges from $6 to $200 [6]. For special needs plans, or SNPs, with a premium, monthly premiums range from $9.90 to $38.90 [7].

Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is at least $170.10 in 2022. (Most people pay this standard amount, but if your income is above a certain threshold, you'll pay more.)

Other out-of-pocket costs to consider include:

Whether the plan covers any part of your monthly Medicare Part B premium.
The plan’s yearly deductibles and any other deductibles, such as a drug deductible.
Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.
The plan’s in-network and out-of-network out-of-pocket maximums.
Whether your medical providers are in-network or out-of-network, or how often you may go out of network for care.
Whether you require extra benefits, and if the plan charges for them.

To get a sense of costs, use Medicare’s Plan Finder to compare information among available plans in your area. You can select by insurance carrier to see only Humana plans, or compare across carriers. You can also shop directly from Humana’s website by entering your ZIP code, and you’ll be able to compare the plans available.

Medicare star ratings

Average star rating: 4.1

The Centers for Medicare & Medicaid Services maintains its own database of star ratings on every Medicare Advantage and separate Medicare Part D plan, ranging from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.

Based on the most recent year of data, Humana’s 2022 Medicare Advantage plans (Part C) get an average rating of 4, and the company’s prescription drug plans (Part D) get an average score of 4.2. The overall average score for Humana’s plans is 4.1 [8]. For comparison, the average star rating for plans from all providers was 4.37 [9].

It’s also worth noting that 97% of Humana's Medicare Advantage members who are in rated contracts are in contracts with 4 stars or more for 2022 [10]. Four Humana contracts in 2022, covering 527,000 members, received 5 stars:

CarePlus Health Plans Inc. in Florida.
Cariten Health Plan Inc. in Tennessee.
Humana Health Benefit Plan of Louisiana Inc. in Louisiana.
Humana Health Plan of Ohio Inc. in Kentucky.

Where did Humana outperform?

To get an overall star rating, the CMS ranks contracts on 40 plan factors. (You can find definitions for each of these factors in the CMS Star Ratings Technical Notes.) Here’s where Humana plans really delivered, with average scores of 4.5 (out of 5) and above:

Care for older adults — medication review.
Care for older adults — pain assessment.
Diabetes care — blood sugar controlled.
Complaints about the health plan.
Plan makes timely decisions about appeals.
Reviewing appeals decisions.
Call center — foreign language interpreter and TTY availability.
Complaints about the drug plan.

Where did Humana struggle?

In some categories, Humana contracts averaged a sub-3 score. (You can find definitions for each of these factors in the CMS Star Ratings Technical Notes.)

Annual flu vaccine.
Monitoring physical activity.
Reducing the risk of falling.
Improving bladder control.

You can find a plan's rating with the Medicare Plan Finder.

Third-party ratings

There are a few companies that weigh in on health plans or on the strength of the company in question, and we’ve included three here:

AM Best Financial Strength Rating: A- (Excellent) for most

AM Best is a credit rating agency that specializes in the insurance industry. In October 2021, AM Best affirmed its Financial Strength Rating of A- (Excellent) for the majority of health and dental insurance subsidiaries of Humana Inc. [11].

AM Best also affirmed an FSR of B++ (Good) for Humana Insurance of Puerto Rico Inc. and Humana Health Plans of Puerto Rico Inc., which are Humana subsidiaries.

An A- rating in this category indicates that AM Best believes Humana has an excellent ability to meet its ongoing insurance obligations. (The two subsidiaries with a B++ rating are deemed to have a “good” ability to meet ongoing insurance obligations.)

J.D. Power Ranking: 4th out of 9

In its 2021 U.S. Medicare Advantage Study — the seventh it's done so far — J.D. Power measured member satisfaction with Medicare Advantage plans based on six factors: coverage and benefits, provider choice, cost, customer service, information and communication, and billing and payment. On these measures, Humana scored 822 points out of 1,000 and came in fourth out of the top nine Medicare Advantage providers. [12]

NCQA Score Range: 2.5 to 4 out of 5

The National Committee for Quality Assurance rates health insurance plans on a 5-point scale (with 5 being best) based on clinical quality, member satisfaction and results from the NCQA’s accreditation survey. The ratings highlight the results of care and what patients say about their care.

In its September 2021 ratings of Humana plans, the NCQA awarded ratings between 2.5 and 4. About half of the rated plans received a 4, and the other half received a 3.5 or lower [13]. Two plans received a 2.5 rating: Humana Insurance Company in Oklahoma and Humana Medical Plan of Michigan Inc.

Compare alternatives

See how Medicare Advantage competitors stack up to Humana.

Compare Medicare Advantage providers
Company	Percent in a 4-star plan or higher	Service area	Average Medicare star rating (2022)
Aetna	87%.	46 states and Washington, D.C.	3.8.
Anthem	72%.	24 states and Puerto Rico.	3.9.
Blue Cross Blue Shield	59%.	44 states.	4.1.
Cigna	87%.	26 states and Washington, D.C.	4.2.
Humana	93%.	47 states and Puerto Rico.	4.1.
Kaiser Permanente	100%.	8 states and Washington, D.C.	5.
UnitedHealthcare	76%.	50 states, Washington, D.C., American Samoa, Guam, the Northern Mariana Islands, Puerto Rico and the U.S. Virgin Islands.	4.2.
Wellcare	26%.	36 states.	3.6.

Find the right Medicare Advantage plan

It’s important to do your research before selecting a health plan for yourself. Here are some questions to consider asking:

What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?
Is your doctor in-network? If you have a preferred medical provider or providers, make sure they participate in the plan’s network.
Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs in, and are there any coverage rules that apply to them?
Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?
Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?

If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).

ARTICLE SOURCES

Works cited

Kaiser Family Foundation, “Medicare Advantage in 2021: Enrollment Update and Key Trends,” accessed Oct. 29, 2021.
J.D. Power, “Retail Health and Wellness Services Surge in Popularity, Driving Significant Gains in Pharmacy Customer Satisfaction, J.D. Power Finds,” accessed Oct. 29, 2021.
Humana, “Humana Medicare Advantage Special Needs Plans (SNPs),” accessed Oct. 29, 2021.
Humana, “Humana Expanding Medicare Advantage Health Plans in 2022 to Address Beneficiaries’ Most Important Needs, Delivering Predictable, Affordable and Understandable Health Care,” accessed Oct. 29, 2021.
The Chartis Group, “As Medicare Advantage Enrollment Booms, Healthcare Entities Need to Plan Around Key Trends,” accessed Oct. 29, 2021.
Centers for Medicare & Medicaid Services, “2022 MA Landscape Source Files (v 09 08 21) (ZIP),” accessed Oct. 29, 2021.
Centers for Medicare & Medicaid Services, “2022 SNP Landscape Source Files (v 09 08 21) (ZIP),” accessed Oct. 29, 2021.
Centers for Medicare & Medicaid Services, “2022 Star Ratings Data Table (Oct 06 2021) (ZIP),” accessed Oct. 29, 2021.
Centers for Medicare & Medicaid Services, “2022 Star Ratings Fact Sheet_10_8_2021 (PDF),” accessed Oct. 29, 2021.
Humana, “97% of Humana’s Medicare Advantage Members Are in Contracts Rated 4-Star or Higher for 2022, Reflecting Strong Commitment to Quality of Care, Patient-Centered Clinical Outcomes and Customer Service,” accessed Oct. 29, 2021.
Business Wire, “AM Best Affirms Credit Ratings of Humana Inc. and Its Health Insurance Subsidiaries,” accessed Oct. 29, 2021.
J.D. Power, "Fewer Medicare Advantage Plan Members Actively Managed Their Health during Pandemic, J.D. Power Finds," accessed Oct. 29, 2021.
NCQA, “Health Plans,” accessed Oct. 29, 2021.

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