Humana Medicare Advantage: A Complete Guide to Humana Medicare

Humana Medicare Advantage is a type of medical insurance plan offered only to the citizens of the United States.

Everyone dreams of a perfect life, but only a few are able to achieve it. This is because most of them make the right decision at the right time in their life, invest in profitable things, and care about their well-being more than anything.

Do you ever wonder why some people remain healthy even at an old age? They go for regular medical check-ups and have a balanced diet that is recommended to them by medical professionals. But not everyone can afford expensive regular medical check-ups, this is why medical insurance exists.

Medical insurance is an important aspect of a healthy lifestyle and a carefree mind. The insurance takes away one’s worries of an emergency or financial loss due to medical expenses. Life is a series of unexpected events, but medical insurance reassures us and makes us capable of facing these events without any complications. So, to live a fulfilling life, you need to buy medical insurance.

Medical insurance is offered by many insurance companies that you can pick based on your preferences. Humana Medicare Advantage is a type of medical insurance plan offered by the Humana insurance company.

You can buy this plan, based on your income and medical condition.

If you are looking for more information about Humana Medicare Advantage, keep reading the article:

What is medical insurance?

Before we jump into the Humana Medicare Advantage plan, it is important for you to know the real definition or meaning behind medical insurance.

Medical insurance is a type of life insurance that focuses on providing maximum medical facilities at an affordable price and preventing financial loss. A person has to sign a contract, filled with terms and agreed policies, with the insurance company to benefit from the insurance. This contract consists of all the benefits to which the insured person agrees before signing. To benefit from medical insurance, one has to pay a premium every month for a certain period of time.

Medical insurance is divided into two sectors, private and public. Private insurance companies offer different facilities and rates compared to public organizations. In America, some private insurance companies also work with government organizations for medical insurance. An individual has the option to choose either of the two based on their preferences.

Why should you buy medical insurance?

Medical insurance is essential for every individual or family. It not only saves the cost of separate treatment but also brings more benefits to you that you can afford. Many individuals who buy medical insurance have positive reviews about it because they find it more beneficial.

People who have no medical insurance are always in constant worry for their health, especially when they are always busy with work. While an insured person goes for regular checkups and screenings which keeps them healthy and fit, all year.

Medical insurance is all about giving benefits to an individual without any financial loss.

Before you read about Humana Medicare Advantage, you should know some of the basic terms used in insurance policies:

  • Deductibles: Every insurance plan has deductibles that the insured person has to follow to gain medical benefits. Deductibles mean a fixed amount that a person has to pay from their pocket before the insurance company covers the cost.
  • Co-insurance: Co-insurance means the percentage that you pay after you have met your deductible limit.
  • Co-payment: The rate set by the insurance company that you have to pay
  • Out-of-pocket maximum: This amount is the limit that you have to reach after paying through deductibles, co-insurance, and copayment, after which the insurance company pays the 100% cost of medical expenses.
  • Premium: The fee that you have to pay to the insurance company on a monthly basis to get the medical benefits of the plan.

Every insurance has these terms mentioned in its plans. The percentages vary based on the coverage you opt to buy for yourself. The more coverage you buy, the more premium you have to pay.

What is Humana Medicare?

Humana is a private insurance company, located in the United States, that offers medical insurance to its members. It is one of the biggest private insurance companies in the U.S with thousands of subscribers.

Medicare is a federal and state government program offered to citizens of the United States to get maximum healthcare benefits at an economical price. This program has partnerships with insurance companies around the U.S to provide facilities to the citizens. Humana is one of those companies.

Humana Medicare is an insurance policy offered by Humana to Medicare members at an affordable price. The Humana Medicare Advantage plans are designed with the approval of the government to benefit the insured person. There are other insurance plans that are offered based on the medical need of the person.

In short, Humana Medicare is a leading insurance program partnership with innovative plans and maximum benefits to its buyers.

Types of Humana Medicare Plans

Humana offers coverage for every medical condition based on the plan you follow. These plans are designed by medical experts and government agents to facilitate the insured person in terms of expenses and benefits. Every plan offers a special service that is specified to a medical condition.

You should also note that Humana Medicare is only for individuals, and not for families. The plans are also made to cater to the individuals only. If you have an elder and you want to buy family health insurance, then you should go for Medicaid insurance plans.

There are many types of Humana Medicare Plans that you can choose to buy based on your medical preferences. Some of them are as follows:

Humana Medicare Advantage plans

Humana Medicare Advantage plans cover the expenses of medical treatments that a normal person might need. These plans are further divided based on the cost and coverage offered by Humana.

Humana Medicare Advantage is offered based on the state you live in. Each area has some specific plans that only the citizens of the region can apply and benefit from. You can check out the Humana website to know the specific information related to your region about the insurance plan.

Medicare Advantage offers three kinds of plans:

Humana Medicare Advantage PPO

Humana Medicare Advantage PPO plan is a category offered by Humana to all Medicare members. This plan offers medical benefits to people without any referral from a primary doctor.

The only condition for this plan is to get treatment from Medicare in-network organizations. If you go for treatment outside the network, you will have to pay the whole bill by yourself.

Humana Medicare Advantage HMO

Humana Medicare Advantage HMO is different from PPO. It offers medical coverage to Medicare members based on the referral of a primary doctor. The insurance company assigns a primary doctor from whom you can for medical checkups. But if you need to go to a specialist, you need a reference from the primary doctor, only then the insurance plan will cover the cost.

This plan also has the condition of getting treatment within the network of healthcare organizations that work with Medicare.

Humana Medicare Advantage PFFS

Humana Medicare Advantage PFFS is offered for the coverage of medical bills. The plan gives the fee-for-free-service benefit to the insured person. Humana determines how much they are going to pay for the medical expense.

This plan is flexible because it depends on the situation but provides maximum benefits when needed. The insurance company is the sole decision-maker on how much it can cover for you, but it is mostly in the favor of the insured person. This plan gives more options than the HMO plan because you have the choice to get treatment from any doctor or medical professional as long as they agree to Medicare fee-for-service coverage. It covers the cost of medical screening, check-ups, prescription drugs, emergency, and preventive care.

Humana is the organization with whom you sign to benefit from either of the plans. More specific Humana Medicare Advantage plans are offered based on the county you live in. You can check more thoroughly from their website.

Humana Medicare Drug plans

An individual who is in constant need of drugs because of their medical condition can suffer from financial loss because of the expenses. Medicare offers drug plans to the people who need coverage for prescribed drugs.

Humana Medicare Drug plans, also known as Medicare Part D,  are solely designed to facilitate its members in buying drugs that are too expensive for their normal wage. It covers a certain percentage cost based on the premium.

You can add drug plans in other plans too. But that depends on if your needs are covered by the plan or not.

Humana Medicare Supplement plans

Medicare Supplement plans cover the cost of medical expenses ranging from Parts A to Part G. These plans are different from other plans because they do not require any primary doctor. Furthermore, you have to be enrolled in Medicare Part A and Part B to get this insurance.

Medicare Supplement plan offers coverage for most Medicare parts, and also additional benefits, unlike other insurance companies. However, it doesn’t cover the cost of treatment for long-term diseases.

Most Medicare plans are included in Humana Medicare too. So, you will need a detailed call with an agent to determine that is perfect for you. There is a separate plan for retired people as well. This retirement plan covers the cost of senior citizens’ medical services based on the plan they buy.

How much does Humana Medicare cost?

Humana is a private insurance organization that offers plans in partnership with Medicare. The plans are Medicare-approved with the decided cost. Humana Medicare costs are different based on the plans you subscribe to.

If you buy an insurance plan with maximum coverage it will be more costly compared to a plan that only covers basic benefits.

So, it depends on individual to individual. Here are some factors that can affect the cost of Humana Medicare plans:

Medical condition

The medical condition of an individual is judged to recommend plans. Humana Medicare Advantage plan cost is also determined based on the medical condition of the person. So, the cost of the plan will be affected.


The age group in which the individual belongs can determine their medical needs. The data and infographics collected by insurance companies help them in recommending a plan that is cost-effective for them.


The income is the most important part of the insurance plan cost. Your income determines whether you are eligible to apply for a certain plan or not.

As Medicare is a government program, they make sure to include every person in the insurance plan by covering costs. But this is a case-by-case criterion based on certain policies and requirements.


The geographical location of the individual also affects the cost of the insurance plan. Humana offers different plans in different regions, and each cost varies from another.

So, the insurance company will determine the cost of an insurance plan based on the region the individual resides officially.

Dental or Vision

Humana Medicare offers a separate coverage plan of dental and vision check-ups that you can include in the insurance plans. The cost of the insurance plan is affected if you add the coverage in.

Cost of Humana Medicare Advantage plan

Humana Medicare Advantage plan costs are based on the aforementioned factors. There are various types of Humana Medicare Advantage by the insurance company that makes it hard to determine the exact cost of the plan.

In the Medicare Advantage plan, there is also a low or $0 premium at Humana. The low or $0 premium cost means that the government covers all the expenses of the individual for the insurance. This is only covered for Humana Medicare Advantage, the person has to pay the full cost of Original Medicare by themselves.

Cost of Humana Medicare Supplement plan

Humana Medicare Supplement consists of coverage from Part A to Part G. Based on each Medicare Part, the cost is different. They have different percentages and rates for deductibles and coinsurance.

You have to be enrolled in Medicare Part A and Part B to see what the cost of premium you have to pay on a monthly basis.

Cost of Humana Medicare Drug plan

The cost of the Humana Medicare Drug plan is based on the cost of the prescribed drugs. There are a total of 5 tiers in the plan that range from low tier to high tier. Every tier has different drugs and the cost of each tier is different.

Every person receives treatment for a different disease, so the monthly premium varies from individual to individual. There are certain brands and formulas mentioned by Humana that the insurance plan covers the cost for.

Most Medicare organizations prescribe drugs that fall under the required brands so that you are able to afford them with the insurance. There are certain deductibles and copays mentioned that you have to follow.

Am I eligible for Humana Medicare?

Before you call or go to apply for Humana Medicare, you should know whether you are eligible to apply or not. If you want to buy a plan, you have to be eligible for the criteria given by Humana.

Medicare is a federal program that is offered by the government to people who are more than 65 years old or have a disability. However, each region has defined the age range for Medicare differently.

Just like every other insurance company that has a partnership with Medicare, Humana also has set the same criteria for the individuals. The only difference between Humana and other companies is that Humana provides more benefits and facilities to individuals.

There are also eligibility criteria for each Medicare plan as well. If you want to buy a Humana Medicare Supplement plan, then you need to be subscribed to Medicare Part A & Part B. For Humana Medicare Advantage, there are no such eligibility criteria but you still have to follow the general criteria of age. The Humana Medicare Drug plan is based on the insurance plan you have included in.

What does Humana Medicare Advantage cover?

Humana provides the best services and facilities in the country. They are known to be one of the largest and most successful companies in the world. Medicare partners with Humana because of its high-quality services that can benefit the old aged and disabled people.

Humana Medicare Advantage is one of the most bought and best plans offered by Humana to Medicare members. It covers all the necessary medical needs that a person requires in their lifetime.

Whether you need medical attention for chronic disease or nursing facility benefits, Humana Medicare Advantage provides the benefit based on the plan you buy. There are different plans that cover various medical needs like insulin saving, dental coverage, primary care cost, Behavioral-health services, etc.

Humana Medicare Advantage premium can also be reduced based on the Social Security account. People have received benefits from Social Security, they have reduced premiums. You can also opt for an over-the-counter (OTC) benefit that basically consists of an allowance limit that you can spend without having any out-of-pocket cost for drugs.

How to apply for Humana Medicare Advantage?

Humana Medicare is one of the top programs offered by the insurance company. The plans are specially made based on the data and infographics collected by the company through detailed research and surveys.

Now that you know all about Humana Medicare, you are ready to apply for Humana Medicare Advantage:


If you are unsure about the Humana Medicare Advantage, you can hire an agent to help you out. Medical insurance agents or Medicare expert agents know all the details about plans offered by Humana.

Although they will take some commission, the plan they will recommend will be the perfect one that is affordable and gives you maximum benefits throughout the year. Humana personally hires agents to whom you can go for consultation as well.

Online website

Humana Medicare has an official webpage on the website of Humana. You can easily browse through the website to know more about Humana Medicare Advantage. Just search and you will be directed to the website.

You can set up an online account on the website that can keep you organized and updated with the insurance plan. For applying, you can simply search for plans through your ZIP code and decide on which plan to buy.

Call customer service

You can always call the customer service provided by Humana to know more information about Humana Medicare Advantage. They will make things clearer for you, and help you pick the best plan based on your medical needs and preferences.


Buying medical insurance is the best decision one can make to better their lifestyle. Medicare offers facilities to old people and disabled people who need medical assistance or frequent medical checkups to remain healthy and fit.

Now that you know everything about Medicare Advantage, if you are eligible for Medicare, you should buy Humana Medicare Advantage to benefit from the facilities provided by the program and the insurance company.

John Otero

John Otero

John Otero is an industry practitioner with more than 15 years of experience in the insurance industry. He has held various senior management roles both in the insurance companies and insurance brokers during this span of time. He began his insurance career in 2004 as an office assistant at an agency in her hometown of Duluth, MN. He got licensed as a producer while working at that agency and progressed to serve as an office manager. Working in the agency is how he fell in love with the industry. He saw firsthand the good that insurance consumers experienced by having the proper protection. John has diverse experience in corporate & consumer insurance services, across a range of vocations. His specialties include Major Corporate risk management and insurance programs, and Financial Lines He has been instrumental in making his firm as one of the leading organizations in the country in generating sustainable rapid growth of the company while maintaining service excellence to clients.