Humana has announced it will stop offering Medicare Advantage plans in certain counties, effective at the end of 2024 and into 2025

Humana, one of the largest Medicare Advantage insurers in the United States, has said it will exit Medicare Advantage markets in multiple states and counties. The company cited financial losses on its Medicare Advantage business as the reason. This means some seniors currently enrolled in a Humana Medicare Advantage plan will need to choose a different plan during the next open enrollment period, which runs from October 15 to December 7 each year.

The pullback affects different regions differently. Humana is not leaving Medicare Advantage entirely — it will continue to serve Medicare Advantage members in many areas — but the counties where it is withdrawing will have fewer plan options for seniors shopping during open enrollment. If you live in an area where Humana is exiting, your current plan will end on December 31 of the announced year, and you will receive a notice from Humana telling you which plans are available to you as alternatives.

Key Takeaways

  • Humana is withdrawing from Medicare Advantage in specific counties, not nationwide, so check whether your county is affected by looking at Humana's announcement or calling 1-800-HUMANA-1.
  • If your Humana plan is being discontinued, you will receive a notice in the mail at least 30 days before your plan ends, and you can switch to a different plan during open enrollment without penalty.
  • Other Medicare Advantage plans, Original Medicare, or Medigap policies may be available in your area as alternatives.
  • You do not have to wait for open enrollment if your plan is being discontinued — you can switch when ready once you receive notice from Humana.

Why Humana is withdrawing from certain markets

Humana reported that its Medicare Advantage business has been losing money in some regions. The company stated that medical costs for its members — the amount it pays out in claims — have been higher than the payments it receives from Medicare. When an insurer's costs consistently exceed its revenue, it typically exits that market rather than continue operating at a loss.

Several factors have contributed to higher medical costs across the Medicare Advantage industry. Seniors are using more healthcare services than some insurers anticipated when they set their premiums and planned their networks. Additionally, the cost of prescription drugs, hospital care, and specialist visits has risen. Humana also cited challenges in accurately predicting which members would need expensive care, making it harder to price plans competitively while still covering costs.

This is not unique to Humana. Other large Medicare Advantage insurers, including UnitedHealthcare and Anthem, have also reduced their presence in certain markets in recent years for similar reasons. The Medicare Advantage market has become more competitive and less profitable for some insurers in specific geographic areas.

Which areas are affected and how to find out

Humana's withdrawals vary by year and region. The company has announced exits in counties across multiple states, but not all counties in those states are affected. For example, Humana might leave certain counties in Florida while continuing to serve other Florida counties.

To find out whether your county is affected, you can:

  • Call Humana directly at 1-800-HUMANA-1 (1-800-486-2621) and ask whether your Medicare Advantage plan will be discontinued.
  • Visit Medicare.gov and use the plan finder tool to see which plans are available in your zip code for the upcoming year.
  • Wait for a notice from Humana in the mail. If your plan is being discontinued, Humana must send you written notice at least 30 days before your coverage ends.

Humana typically announces its market exits in the spring or early summer, giving seniors several months to prepare before open enrollment begins in October.

What happens to your coverage if your plan is discontinued

If you are currently enrolled in a Humana Medicare Advantage plan that is being discontinued, your coverage will end on December 31 of the year Humana exits your market. You will not lose coverage abruptly — instead, you will have time to choose a new plan.

Once you receive notice from Humana that your plan is ending, you can switch to a different Medicare Advantage plan, return to Original Medicare, or enroll in a Medigap policy. You do not have to wait for the standard open enrollment period (October 15 to December 7) to make this change. Instead, you have what Medicare calls a "Special Enrollment Period," which typically lasts from the time you receive Humana's notice until 60 days after your current plan ends. During this window, you can switch plans without any waiting periods or penalties.

Any out-of-pocket costs you have paid toward your deductible with Humana will not carry over to a new plan. If you switch to Original Medicare or a different Medicare Advantage plan, your deductible resets on January 1 of the new year.

How to choose a new plan after Humana exits your area

When your Humana plan ends, you will need to decide among the plans still available in your county. Your options typically include other Medicare Advantage plans, Original Medicare paired with a Medigap policy, or Original Medicare with a separate prescription drug plan (Part D).

To compare plans, use the Medicare plan finder at Medicare.gov. Enter your zip code and the year you need coverage for, and the tool will show you all available plans, their premiums, deductibles, copays, and which doctors and hospitals are in-network. You can also call 1-800-MEDICARE (1-800-633-4227) and speak with a Medicare counselor who can walk you through your options.

When comparing plans, pay attention to whether your current doctors and hospitals are in-network. If you have a preferred primary care doctor or specialist, confirm that they accept the new plan before you enroll. Also check the formulary — the list of covered prescription drugs — to make sure your medications are covered at a cost you can afford.

Other Medicare Advantage insurers in your area

Even though Humana is leaving certain markets, other Medicare Advantage insurers typically remain. The largest national Medicare Advantage insurers include UnitedHealthcare, Anthem (which includes Blue Cross Blue Shield plans in many states), Aetna, and Cigna. Regional insurers also offer Medicare Advantage plans in many areas.

The number of plans available to you depends on where you live. Urban and suburban areas usually have more options than rural areas. Some counties may have only a few Medicare Advantage plans available after Humana exits, while others may have a dozen or more. The Medicare plan finder will show you exactly how many plans are available in your zip code.

If you are concerned about having fewer plan options, you can also choose to switch to Original Medicare instead of selecting another Medicare Advantage plan. Original Medicare is accepted by nearly all doctors and hospitals nationwide, which can be valuable if you travel frequently or want maximum flexibility in choosing providers.

Frequently Asked Questions

Will I lose coverage if Humana exits my market?

No. Your Humana plan will end on a specific date, but you will have time to choose a new plan before that date arrives. You can switch to another Medicare Advantage plan, Original Medicare, or a Medigap policy. You will not have a gap in coverage as long as you enroll in a new plan before your current one ends.

Can I stay with Humana if I move to a county where it still operates?

If you move to a different county where Humana still offers Medicare Advantage plans, you may be able to keep your Humana coverage. However, you will need to update your address with Medicare and Humana, and your plan details may change. Call Humana at 1-800-HUMANA-1 to confirm whether your new address is in a service area.

What if I do not choose a new plan before my Humana plan ends?

If you do not enroll in a new plan by December 31, you will lose your Medicare Advantage coverage on that date. You can still enroll in Original Medicare or another plan during the next open enrollment period (October 15 to December 7), but you may face a late enrollment penalty on your Part B or Part D premiums if you wait. It is best to choose a new plan during your Special Enrollment Period.

Do I have to choose a Medicare Advantage plan, or can I switch to Original Medicare?

You can choose either. If you switch to Original Medicare, you will also need to enroll in a Part D prescription drug plan and may want to purchase a Medigap policy to cover costs that Original Medicare does not pay. Original Medicare is accepted nationwide, while Medicare Advantage plans have geographic service areas.

When will I know if Humana is leaving my area?

Humana typically announces market exits in the spring, and you will receive a formal notice in the mail at least 30 days before your plan ends. You can also check Medicare.gov or call 1-800-MEDICARE to find out whether Humana plans will be available in your area for the upcoming year.