Humana Medicare Advantage 2022 Review

Humana Medicare Advantage is the most widely available provider in the U.S. with a selection of highly rated plans.
Jul 13, 2022

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Humana was the second-largest provider of Medicare Advantage plans in 2021

, 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 98% 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

    .

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

    .

  • 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.

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 expanded into 47 states in its third year of operation.

Other plan offerings include the following types:

HMO plans

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.

PPO plans

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.

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.

Additional benefits

Humana Medicare Advantage offers most members access to routine visiondental 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:

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

Kaiser Family Foundation. Medicare Advantage 2022 Spotlight: First Look. Accessed Jul 12, 2022.
.

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

.

Overall, Humana is the second-largest health insurer among for-profit health plans

. More than 5.1 million Medicare beneficiaries are enrolled in a Humana Medicare Advantage plan as of June 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 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

Centers for Medicare & Medicaid Services. 2022 MA Landscape Source Files (v 10 26 21) (ZIP). Accessed Jul 12, 2022.
. For special needs plans, or SNPs, with a premium, monthly premiums range from $9.90 to $38.90.

Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is at least $170.10 per month 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 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: 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.

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, Humana’s 2022 Medicare Advantage plans get an average rating of 4 stars for health plan measures and an average of 4.3 stars on prescription drug coverage measures. The overall average score for Humana’s plans is 4.1 stars

Centers for Medicare & Medicaid Services. 2022 Star Ratings Data Table (Oct 06 2021) (ZIP). Accessed Jul 12, 2022.
.

For comparison, the average star rating for plans from all providers was 4.37

Centers for Medicare & Medicaid Services. 2022 Star Ratings Fact Sheet_10_8_2021 (PDF). Accessed Jul 12, 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 June 2022. Four Humana contracts in 2022, covering about 560,000 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 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 October 2021, 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: 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

.

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. Two plans received a 2.5 rating: Humana Insurance Company in Oklahoma and Humana Medical Plan of Michigan Inc

NCQA. Health Plans. Accessed Jul 12, 2022.
.

Compare alternatives

See how Medicare Advantage competitors stack up to Humana.

Compare Medicare Advantage providers

Percent in a 4-star plan or higher: 85%.

Service area: 46 states and Washington, D.C.

Average Medicare star rating: 3.8 stars.

Percent in a 4-star plan or higher: 72%.

Service area: 24 states and Puerto Rico.

Average Medicare star rating: 3.9 stars.

Percent in a 4-star plan or higher: 85%.

Service area: 44 states.

Average Medicare star rating: 4.1 stars.

Percent in a 4-star plan or higher: 87%.

Service area: 26 states and Washington, D.C.

Average Medicare star rating: 4.2 stars.

Percent in a 4-star plan or higher: 98%.

Service area: 47 states and Puerto Rico.

Average Medicare star rating: 4.1 stars.

Percent in a 4-star plan or higher: 100%.

Service area: 8 states and Washington, D.C.

Average Medicare star rating: 5 stars.

Percent in a 4-star plan or higher: 95%.

Service area: 50 states, Washington, D.C., American Samoa, Guam, the Northern Mariana Islands, Puerto Rico and the U.S. Virgin Islands.

Average Medicare star rating: 4.2 stars.

Percent in a 4-star plan or higher: 53%.

Service area: 36 states.

Average Medicare star rating: 3.6 stars.

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 2021, Humana covers nearly 8.6 million Medicare members in the U.S.

Humana posted total revenues of $83 billion in 2021.

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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