How to know if another plan fits you better than Humana

Whether a different Medicare Advantage plan is better than Humana depends on what matters most to you: your doctors, your medications, your budget, or how much travel you do. Humana works well for some people and poorly for others in the same town, because networks differ and drug formularies change every year. The only way to know if you should switch is to check three things: whether your doctors are in-network at other plans, whether your medications cost less elsewhere, and whether the out-of-pocket limits fit your health needs.

This guide walks you through how to compare plans side by side and what to look for when you are deciding whether to stay or switch. You do not have to switch every year, but the information changes enough that it is worth checking during open enrollment (October 15 through December 7 each year).

Key Takeaways

  • Your current doctors and specialists may not be in-network at other plans, so check the provider directory for each plan you are considering before anything else.
  • Medication costs vary widely between plans even within the same insurance company, so use the plan's formulary tool to price your prescriptions at each option.
  • Out-of-pocket maximums, copays for specialists, and hospital deductibles differ enough to matter if you have chronic conditions or expect significant medical care.
  • You can switch plans during open enrollment (October 15 to December 7) or if you have a may have access to life event like moving to a new state.
  • Medicare.gov's plan comparison tool lets you enter your doctors and medications and see costs side by side without contacting insurers.

Check your doctors first — this is the hardest thing to change

Before you look at premiums or deductibles, find out whether your primary care doctor and any specialists you see regularly are in-network at the plans you are considering. If your cardiologist is not in-network, switching plans to save $50 a month on premiums will cost you far more in out-of-network bills or the hassle of finding a new doctor.

Go to each plan's website and use their provider search tool. Search for your doctor by name and location. Write down whether they show as "in-network" or "out-of-network." If the search tool is hard to use or you cannot find your doctor listed, call the plan's customer service number and ask directly. Do this for your primary care doctor, any cardiologist, rheumatologist, oncologist, or other specialist you see regularly, and your preferred hospital or urgent care clinic.

If your current doctors are not in-network at another plan, you have two choices: find a new doctor in that plan's network, or stay with Humana. There is no shame in staying because your doctor is there. That is a legitimate reason.

Compare medication costs using each plan's formulary

Medication costs are often the biggest difference between plans. Two plans from the same insurance company can have different formularies — the list of drugs they cover and what you pay for each one. If you take three or four regular medications, the difference in copays can add up to hundreds of dollars a year.

Start by listing every medication you take, including the dose and how often you refill it. Then go to each plan's website and look for the formulary tool or drug search. Enter each medication and note the copay or coinsurance (the percentage you pay). Some plans charge a flat $10 copay for generic drugs; others charge 20 percent of the cost. Some put your medications in a higher tier that costs more.

Add up the annual cost for all your medications at each plan. Include the copays you would pay after you meet your deductible. If one plan costs $600 a year less in medication costs, that matters even if the premium is $20 higher per month.

Look at out-of-pocket limits and specialist copays

Medicare Advantage plans have an out-of-pocket maximum — the most you will pay in a year for covered services. Once you hit that number, the plan pays 100 percent of covered costs for the rest of the year. In 2024, these maximums ranged from around $6,700 to $10,000 depending on the plan, but these numbers change yearly.

If you have a chronic condition like diabetes or heart disease, or if you expect surgery or significant medical care this year, compare the out-of-pocket maximums across plans. A plan with a lower maximum might have a higher premium, but if you know you will hit that maximum anyway, the lower maximum saves you money overall.

Also check the copay for specialist visits. Some plans charge $30 to see a specialist; others charge $50 or more. If you see a cardiologist four times a year, that difference adds up. Look at the copay for urgent care visits and emergency room visits too, because these vary.

Other Medicare Advantage plans to research

In most areas, you have several Medicare Advantage options beyond Humana. The major national insurers are UnitedHealthcare, Aetna, Cigna, and Blue Cross Blue Shield (which operates under different names in different states). Smaller regional plans also operate in many areas. During open enrollment, Medicare.gov shows you every plan available in your zip code.

You do not need to research every plan. Start by looking at plans from the insurers that already serve your area well. If you have had good experiences with UnitedHealthcare or Aetna in the past, start there. If you have heard good things about a regional plan from friends or your doctor's office, add that to your list. Then use the comparison steps above — doctors, medications, out-of-pocket costs — to narrow it down to two or three finalists.

Some people find that Original Medicare (Part A and Part B) plus a Medigap supplemental plan works better than any Medicare Advantage plan, especially if they travel frequently or see many specialists. Medigap plans cover costs that Original Medicare does not, but they have higher premiums and no out-of-pocket maximum. This is a bigger decision than switching between two Advantage plans, but it is worth understanding as an option.

Use Medicare.gov to compare plans side by side

Medicare.gov has a plan comparison tool that does much of this work for you. Go to Medicare.gov, click "Find Care Providers," and enter your zip code. You can then search for your doctors and medications, and the tool will show you which plans cover them and at what cost.

You can also go directly to the "Compare Plans" section and enter your medications. The tool shows you the premium, deductible, copays, and out-of-pocket maximum for each plan side by side. Print or save the comparison so you can review it carefully. This tool is free and does not require you to contact any insurance company.

If you find a plan you want to learn more about, you can call the plan directly or visit their website. Many plans have enrollment specialists who can answer questions about coverage and help you understand what switching would mean for your specific situation.

When you can switch and what to do

You can change Medicare Advantage plans during the annual open enrollment period, which runs from October 15 through December 7 each year. Any plan you choose during this window becomes active on January 1. You can also switch if you have a may have access to life event, such as moving to a new state, losing employer coverage, or becoming newly may be able to access for Medicaid.

To switch, you can enroll in the new plan through Medicare.gov, by phone at 1-800-MEDICARE, or directly through the new plan's website. You do not need to contact Humana to leave; the new plan handles the switch. Your Humana coverage ends on December 31, and your new plan begins January 1 (or the first of the month after a may have access to event).

If you switch plans, make sure you understand your new plan's rules before January 1. Know which doctors are in-network, how to order prescriptions, and what your copays are. Call your new plan's customer service line if you have questions. The first few weeks in a new plan can feel confusing, but the information is there if you ask.

Frequently Asked Questions

What if my doctor is in-network at Humana but out-of-network at every other plan in my area?

Stay with Humana. Switching plans to save money on premiums or copays is not worth losing access to a doctor you trust. You can always revisit this decision next year if the networks change.

Can I switch plans more than once a year?

You can switch during open enrollment (October 15 to December 7) once per year. If you have a may have access to life event — such as moving, losing coverage, or becoming may be able to access for Medicaid — you can switch outside of open enrollment. Call 1-800-MEDICARE to find out whether your situation qualifies.

If I switch plans, do I lose my current prescriptions?

Your prescriptions do not transfer automatically, but your new plan's pharmacy can usually fill them on day one. Before you switch, check whether your pharmacy is in-network at the new plan. If it is not, you may need to switch pharmacies or ask for an exception from the new plan.

What happens to my Humana coverage if I enroll in a different plan?

Your Humana coverage ends on December 31 (or the last day of the month in which you switch due to a may have access to event). Your new plan's coverage begins the next day. You do not need to contact Humana; the new plan handles the transition.

Is Original Medicare better than Medicare Advantage?

It depends on your health, your doctors, and how much you travel. Original Medicare has no network restrictions and works nationwide, but it has higher out-of-pocket costs and requires a separate Medigap plan to cover gaps. Medicare Advantage has lower premiums and out-of-pocket maximums but limits you to in-network providers. Compare both options during open enrollment using Medicare.gov.