Humana Medicare Advantage 2023 Review

Humana is the most widely available Medicare Advantage provider in the U.S., with a selection of highly rated plans.
Kate Ashford, CSA®
By Kate Ashford, CSA® 
Edited by Holly Carey

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Humana is the second-largest provider of Medicare Advantage plans in 2022

, and the provider that’s available to the most people, with plans offered in more than nine 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, there are a few contracts with lower scores, 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 2,875 U.S. counties (more than 91% of total counties), Humana is an option for more Americans than any other provider.

  • Quality plans: Humana has 30 contracts rated 4 stars or higher (out of 5) for 2023; these contracts include nearly all of its existing Medicare Advantage members. Three 2023 contracts received 5 stars.

  • Improved member ratings: Humana ranks second out of nine major providers in J.D. Power’s 2022 Medicare Advantage member satisfaction index, up from fourth place in 2021.

  • Veteran focus: Humana Honor plans are designed to work with veteran benefits to provide a complete package of health care for those who served.

Cons

  • Special needs plans (SNPs) aren’t available everywhere: Currently, Humana’s Dual-Eligible SNPs are available in 33 U.S. states and Puerto Rico, and the company’s Chronic Condition SNPs are available in only 18 states

    .

  • Mixed reviews: Although Humana's member satisfaction ratings have improved since last year, the National Committee for Quality Assurance gives several Humana plans a 3 or below out of 5 on its ratings scale.

Available Humana Medicare Advantage plans

Humana offers several kinds of Medicare Advantage plans, and they vary in structure, costs and available benefits. 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. And Humana and USAA have partnered to offer the Humana USAA Honor with Rx plan, another plan in the Humana Honor family, which is aimed toward U.S. military veterans.

Other plan offerings include the following types:

A Medicare 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.

Medicare 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.

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.

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 conditions such as diabetes mellitus, cardiovascular disorders, chronic heart failure or chronic lung disorders.

  • Dual-Eligible SNP: For people who are entitled to Medicare and who also qualify for assistance from a state Medicaid program.

Additional benefits

Humana Medicare Advantage offers most members access to routine vision and dental 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.

  • 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 to purchase approved healthy food and beverages.

  • Healthy Options Allowance: Some members of Humana’s D-SNPs, as well as some members with chronic health conditions, will get access to a yearly allowance of up to $3,300 that they can put toward groceries, over-the-counter items, rent, utilities, pet care products or disaster relief supplies, among other things.

  • Telehealth: All Medicare Advantage members get $0 telehealth copays for most visits with a primary care doctor, urgent care or outpatient behavioral health.

  • Papa Pals: On some plans, members experiencing loneliness may be eligible to receive companionship and general support for up to eight hours a month. The program pairs members with college students who can help with grocery shopping and light housekeeping, among other things.

  • HMO travel benefit: Members of Humana’s HMO Open Access plans will be able to get non-emergency care from network HMO providers when they travel outside their home service area.

Customer service

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

Humana Medicare Advantage service area

Humana offers Medicare Advantage plans in 49 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 91% of U.S. counties — the most of any provider.

For the 2023 plan year, Humana expanded its HMO offerings into 260 new counties and introduced local PPO plans in 260 new counties. The company also expanded D-SNPs into 184 new counties

.

Overall, Humana is the second-largest health insurer among for-profit health plans, adding 315,000 new Medicare Advantage members for the 2022 plan year

. Nearly 5 million Medicare beneficiaries are enrolled in a Humana Medicare Advantage plan as of September 2022.

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 2023, about 6 out of 10 (62%) of Humana’s Medicare Advantage plans have a $0 premium.

For 2023 Medicare Advantage plans with a premium, the monthly consolidated premium (including Part C and Part D) ranges from $4 to $199. For special needs plans, or SNPs, with a premium, monthly premiums range from $4.10 to $39.90

Centers for Medicare & Medicaid Services. 2023 MA Landscape Source File (v 09 06 2022) (ZIP). Accessed Oct 14, 2022.
.

Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is at least $164.90 per month in 2023. (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 finding tool 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, weighted by enrollment: 4.35

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.

All Medicare Advantage plans are evaluated on health plan measures, and Medicare Advantage plans that include prescription drug coverage are also evaluated on drug plan measures. Based on the most recent year of data and weighted by enrollment, Humana’s 2023 Medicare Advantage plans get an average rating of 4.35 stars

Centers for Medicare & Medicaid Services. 2023 Star Ratings Data Table (ZIP). Accessed Oct 14, 2022.
.

For comparison, the average star rating for plans from all providers in 2023 is 4.15

Centers for Medicare & Medicaid Services. 2023 Medicare Star Ratings Fact Sheet. Accessed Oct 14, 2022.
.

It’s also worth noting that 98% of Humana's Medicare Advantage members who are in rated contracts are in contracts with 4 stars or more as of September 2022. Three Humana contracts in 2023, covering about 356,000 members, received 5 stars:

  • Cariten Health Plan Inc. in Tennessee.

  • Humana Health Benefit Plan of Louisiana Inc. in Louisiana.

  • Humana Health Plan of Ohio Inc. in Kentucky.

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.

  • Medication reconciliation post-discharge.

  • Complaints about the health plan.

  • Plan makes timely decisions about appeals.

  • Reviewing appeals decisions.

  • Health plan: Call center — foreign language interpreter and TTY availability.

  • Drug plan: Call center — foreign language interpreter and TTY availability.

  • Complaints about the drug plan.

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.

  • Osteoporosis management in women who had a fracture.

  • Reducing the risk of falling.

  • Improving bladder control.

  • Health plan quality improvement.

  • Drug plan quality improvement.

You can find a plan's rating with the Medicare plan finding tool.

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 September 2022, AM Best affirmed its Financial Strength Rating of A- (Excellent) for the majority of health and dental insurance subsidiaries of Humana Inc.

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: 2nd out of 9

In its 2022 U.S. Medicare Advantage Study — the eighth 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 824 points out of 1,000 and came in second out of the top nine Medicare Advantage providers

.

NCQA Score Range: 2.5 to 4.0 out of 5

The National Committee for Quality Assurance rates health insurance plans on a 5-point scale (with 5 being best) based on quality of care, patient satisfaction and health plans’ efforts to keep improving.

In its September 2022 ratings of Humana plans, the NCQA awarded ratings between 2.5 and 4.0 stars. About 40% of the rated plans received a 4.0, and the rest received a 3.5 or lower. Three plans received a 2.5 rating: Humana Insurance Company in Florida, Humana Insurance Company in Oklahoma and Humana Medical Plan of Michigan Inc

NCQA. Health Plans. Accessed Oct 14, 2022.
.

Compare Medicare Advantage providers

Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.

About Humana

Humana was founded in 1961 and is headquartered in Louisville, Kentucky.

Humana’s insurance offerings include medical, dental, vision and pharmacy benefits. The company offers both individual and group health insurance, including Medicare Advantage plans, Medicare prescription drug plans and Medicare Supplement Insurance. As of June 2022, Humana covers nearly 8.7 million Medicare members in the U.S.

Humana posted total revenues of $83 billion in 2021.

Read the NerdWallet reviews of these other Humana Medicare offerings:

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).
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