When shopping for private Medicare coverage, it’s important to find a company with a good reputation and a long history of providing quality insurance coverage. It’s also very important to have a clear plan for your health and health care needs. By combining these two concepts, you’ll be able to find and enroll in a plan that meets your unique needs. Humana is one of the largest and most popular health insurance companies in America. You should give strong consideration to a Humana Medicare Plan as part of your health insurance coverage.
Humana began in 1961 as a nursing home company. It grew to become the largest nursing home company in the United States, but the founders sold the company in 1972 in order to purchase hospitals. Through a series of mergers and acquisitions, Humana grew to become the world’s largest hospital company.
As a hospital company, Humana started to be affected by the changing health insurance landscape in America during the 1980s. After they lost a contract with a health insurance plan, they decided to form their own health insurance company. The company split the hospital business off from the insurance plan by creating a separate company for each. They eventually sold off the hospital business to focus on health insurance.
Humana is a for-profit health insurance company headquartered in Louisville, Kentucky. As of 2014, Humana was the third largest health insurer in the country, and is ranked in the top 50 of the Fortune 500.
Humana is an important part of the private Medicare Plans market. They have a major presence in all three kinds of private Medicare Plan:
They are active in all 50 states.
Before we go into the specifics of how Humana Medicare Plans work, and how they are perceived in the marketplace, we’ll review a brief history of the Original Medicare program and how it works. This will give a better understanding of why there are private Medicare options in the first place, and why you need to consider one for your own coverage.
Medicare began in 1966 as a government program to provide affordable health insurance to retirees. The goal was to make both the health insurance coverage affordable as well as the health care received through the program. While the program was designed to be affordable, it wasn’t intended to be free. Instead, there are various costs that you’ll be expected to pay. These costs include both costs for coverage and costs for receiving care.
The costs for coverage include both tax payments and premiums. Most people pay for Part A, which is the hospital insurance portion of Medicare, through payroll taxes. You pay taxes out of your paycheck, and your employer matches the amounts that you pay. You pay these taxes all during your working career. In this way, you pre-fund your Part A coverage. If you don’t work enough (or at all), you can receive Part A through a spouse, as long as they worked enough to qualify for premium-free Part A. If you didn’t work long enough, and also aren’t married to a spouse who did, you can choose to enroll in Part A anyway and pay a monthly premium for coverage.
You’ll pay for Part B through a monthly premium. Unlike Part A, which you pay before your coverage ever starts, you’ll only pay the Part B premium when you enter the program. For most people, this happens at age 65 or later, although it is possible to start Medicare early in certain circumstances.
These are the costs you’ll pay just to have Medicare. Next, we’ll investigate the costs you’ll pay when you actually use your Medicare benefits.
The costs you’ll face using your benefits differ between Part A and B, just like the costs for coverage.
For Medicare Part A, you’ll have to pay these costs:
In addition to these costs that you’ll have to pay, which are frequently called “gaps” in your coverage, you’ll also be responsible for these services:
It is because of these gaps and costs that the private Medicare plans exist. Since the costs you’ll pay in Medicare are not capped in any way, the potential exists that you’ll face high out of pocket charges if you suffer a serious health crisis or illness.
Let’s take a look at all of the private options for helping you reduce your spending.
Medicare Supplement Insurance, or Medigap as it’s also called, is the oldest of the three private plan types. It is also both the simplest of the three and the most comprehensive. Medigap works by filling in some of the gaps that you would normally have to pay yourself. Medigap is a secondary coverage; it works only with Original Medicare, and doesn’t provide any benefits on its own.
When you have Humana Medicare Supplement Insurance, you’ll use it whenever you use Part A or B benefits. So, if you should be hospitalized, you’ll use both Original Medicare and your Medigap plan card. Likewise, when you go to the doctor or receive lab work, you’ll pay with both cards as well.
Your provider will bill Medicare first. As long as you’ve met your deductible for the year, they will pay the first 80% for Part B services. Your provider will bill your Humana Medicare Supplement plan for the remaining 20%. Depending on which level of Medigap coverage you have in place, your plan will pay most (or all) of the remaining 20%. You might have to pay a small remaining amount.
As mentioned above, there are various levels of coverage available with Medigap coverage. There are ten standardized plans, which are available in 47 states. The benefits for each option are identical throughout the 47 standardized states. Since the benefits are uniform, you can choose the level of coverage you want; that way you don’t pay for more coverage than you need.
Humana is also a major participant in the Medicare Advantage program, which is technically known as Part C of Medicare. Medicare Advantage plans are a way to receive your Medicare benefits (both Parts A and B) through a private health insurance company, in this case, Humana.
Medicare Advantage Plans help you manage your medical spending by negotiating prices for medical services and procedures directly with providers. The plan pays a certain amount of the cost, and you pay costs that are generally in the form of fixed co-payments. One of the key features of a Medicare Advantage Plan is that it provides an annual Out of Pocket Maximum (OOPM), which protects you from uncontrolled out of pocket spending if you have a medical emergency.
Medicare Advantage plans also help close some of the service-gaps in Original Medicare by providing so-called “extra benefits,” which are coverages for things not covered by Part A or B. These extra benefits can include:
Most Medicare Advantage Plans feature networks of providers who have agreed to accept the plan. You’ll generally need to choose a Primary Care Physician, who is responsible to help you manage your healthcare. Depending on the specifics of your plan, you may be required to use network physicians (if you have an HMO). Or, you may be able to use non-network providers if you have a PPO plan. Humana Medicare Advantage Plans come in both varieties.
Humana also offers Part D drug plans throughout the United States. These standalone drug plans are needed when you stick with Original Medicare rather than using Medicare Advantage Plans. These drug plans are often paired with Medicare Supplement Insurance.
Part D drug plans help reduce the cost of prescription medications. When you have Part D drug coverage, you’ll still have to pay certain costs, including:
You’ll pay co-payments for your medications once you’ve met the deductible. You’ll keep paying these co-payments all throughout the year; there is no annual cap on your drug spending like there is with a Medicare Advantage plan.
Not all of them do. But, there are some Humana plans that will provide emergency coverage internationally.
You can only combine Medicare Supplement and Part D drug plans. You can’t combine a Part D drug plan with most Medicare Advantage plans, or combine Medicare Advantage with Medicare Supplement.
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