Humana is a major Medicare insurance company with multiple plan types

Humana is one of the largest private insurers offering Medicare plans in the United States. The company sells Medicare Advantage plans (Part C), Medigap policies (supplemental coverage), and prescription drug plans (Part D) in most states. If you see Humana listed as an option during your Medicare enrollment, it means the company operates in your area and has been approved by Medicare to sell those specific plan types.

Humana does not replace Medicare itself — it works alongside it. When you choose a Humana plan, you keep your Medicare coverage and add Humana's insurance on top. The way Humana works depends on which type of plan you pick, and the costs, coverage, and doctors available change from year to year and from one state to another.

Key Takeaways

  • Humana offers Medicare Advantage, Medigap, and prescription drug plans, but not all types are sold in every state or county.
  • Medicare Advantage plans through Humana usually have lower monthly premiums than Original Medicare plus Medigap, but require you to use Humana's network of doctors and hospitals.
  • Medigap policies from Humana cover some of the costs that Original Medicare does not pay, such as copayments and coinsurance.
  • You can change Humana plans or switch to a different company during the annual enrollment period from October 15 to December 7, or if you may have access to for a special enrollment period.
  • Humana's coverage, costs, and provider networks vary by location, so you must check what is sold in your zip code before deciding.

How Humana Medicare Advantage plans work

A Medicare Advantage plan from Humana is an all-in-one alternative to Original Medicare. Instead of going to any doctor who accepts Medicare, you choose doctors and hospitals within Humana's network. In return, Humana usually charges a lower monthly premium than you would pay for Original Medicare plus a Medigap policy.

Most Humana Medicare Advantage plans include prescription drug coverage built in, so you do not need to buy a separate Part D plan. Many also offer dental, vision, or hearing coverage that Original Medicare does not provide. However, you pay a copay or coinsurance each time you use a service, and Humana sets an annual out-of-pocket limit — once you reach that limit, Humana covers the rest of your care for the year.

If you need care from a doctor outside Humana's network, you usually pay more or the plan may not cover it at all. Some Humana Medicare Advantage plans allow out-of-network care in emergencies or for certain services, but the rules vary by plan. Before you enroll, check whether your current doctors are in the Humana network in your area.

How Humana Medigap policies work

A Medigap policy from Humana is supplemental insurance that works with Original Medicare, not instead of it. You keep your Medicare coverage and add Humana's policy to cover some of the costs that Medicare does not pay — such as copayments, coinsurance, and deductibles.

Medigap policies are standardized by the federal government, so a Humana Medigap Plan G covers the same benefits as a Plan G from any other company. The difference is the monthly premium Humana charges and whether Humana is available in your state. Humana does not sell Medigap in all states, so you may not have the option to buy from them even if they sell Medicare Advantage in your area.

With a Medigap policy, you can see any doctor or hospital that accepts Medicare — you are not limited to a network. You do not need to get referrals or prior approval from Humana for most care. This flexibility costs more in monthly premiums than a Medicare Advantage plan, but you have more choice in providers.

Prescription drug coverage through Humana

If you choose Original Medicare plus a Humana Medigap policy, you still need prescription drug coverage. Humana sells Part D plans that cover medications at pharmacies nationwide. If you enroll in a Humana Medicare Advantage plan, prescription drug coverage is usually included, so you do not buy a separate Part D plan.

Humana's Part D plans have different costs and cover different medications. The company publishes a formulary — a list of drugs the plan covers — and you can check whether your medications are on it before you enroll. If a drug you take is not covered, you can ask your doctor for an alternative or request that Humana cover it anyway, though the company may say no.

Part D premiums, copays, and which pharmacies are in-network change each year. Even if you were happy with a Humana Part D plan last year, you should review it again during open enrollment to see whether the cost or coverage changed.

Costs and what to compare

Humana Medicare plans have different costs depending on the plan type and where you live. Medicare Advantage plans typically have a monthly premium of $0 to $200, though some plans cost more. Medigap policies from Humana vary widely in price by state and age. Part D plans have a monthly premium, and you also pay copays when you fill prescriptions.

When comparing Humana plans to other companies or to Original Medicare, look at the total cost you would pay in a year, not just the monthly premium. Add up the monthly premium, the annual deductible, copays for the services you use most, and any out-of-pocket limits. A plan with a low premium might have high copays, so the cheapest-looking option is not always the least expensive overall.

You can compare Humana plans and other companies' plans on Medicare.gov using the Plan Finder tool. You enter your zip code, your medications, and your doctors, and the tool shows you which plans cover them and what the costs would be. This is the most accurate way to see what Humana offers in your area and how it compares to other options.

When you can enroll in or change Humana plans

If you are new to Medicare, you can enroll in a Humana plan during your initial enrollment period, which begins three months before the month you turn 65 and ends three months after. If you miss this window, you may pay a penalty for the rest of your life, so the timing matters.

If you already have Medicare, you can change to a Humana plan or switch between Humana plans during the annual open enrollment period, which runs from October 15 to December 7 each year. Changes take effect on January 1. You do not need a reason to switch during this time — you can change plans for any reason or no reason.

Outside of open enrollment, you can change plans only if you may have access to for a special enrollment period. This happens if you move to a new state or county, lose your current coverage, or experience certain life events. If you think you may have access to, contact Humana or Medicare to ask.

Questions to ask Humana before you enroll

Before you sign up for a Humana plan, get answers to these questions so you know what you are choosing:

  • Are my current doctors and the hospital I use in Humana's network for this plan?
  • What is the monthly premium, annual deductible, and out-of-pocket limit for this plan?
  • What copays or coinsurance do I pay for the services I use most — such as doctor visits, specialist visits, or hospital stays?
  • If this is a Medicare Advantage plan, can I see doctors outside the network, and if so, what do I pay?
  • If this is a Medigap or Part D plan, what is the formulary, and are my medications covered?
  • What happens to my coverage if I move to a different state?
  • How do I contact Humana customer service, and what are the hours?

Writing down the answers helps you compare Humana to other plans and remember what you chose. Keep this information with your plan documents so you can refer back to it during the year.

Frequently Asked Questions

Does Humana sell Medicare plans in my state?

Humana sells Medicare Advantage and Part D plans in most states, but not all. Medigap availability is more limited. The easiest way to find out is to go to Medicare.gov, click Plan Finder, enter your zip code, and see which Humana plans appear. If nothing shows up, Humana does not sell that plan type in your area.

Can I use my Humana Medicare plan if I travel or move?

Medicare Advantage plans are usually limited to a specific service area, so if you travel outside it, you may not be covered except in emergencies. If you move to a different state or county, your Humana plan may no longer be sold there, and you would need to switch to a different plan. Medigap and Part D plans work nationwide, so you can use them anywhere.

What if I am unhappy with my Humana plan after I enroll?

You have a 14-day period after your coverage starts to cancel the plan without penalty. After that, you are locked in until the next open enrollment period in October, unless you may have access to for a special enrollment period. If something changes — such as your doctor leaving the network — contact Humana to see whether you may have access to to switch.

How do I know if Humana will cover a specific medication or procedure?

For medications, check the plan's formulary on Humana's website or call Humana customer service. For procedures or services, call Humana and ask whether the service is covered under your plan and what you would pay. Some services require prior approval from Humana before you have them done.

What is the difference between a Humana Medicare Advantage plan and Original Medicare?

Original Medicare is run by the federal government and covers any doctor or hospital that accepts Medicare. Humana Medicare Advantage is run by Humana and limits you to its network, but usually costs less and includes prescription drug coverage. Original Medicare does not include prescription drugs or dental, vision, or hearing coverage unless you buy them separately.