Medicare Advantage (Part C) plans are offered by private insurance companies. In this article, we go through the plans offered by Humana in 2025.
If you’ve already decided to go with a Medicare Advantage (Medicare Part C) plan, you still have some decisions. One of these is the insurance provider that will supply your coverage.
Humana is a for-profit health insurance company based in Kentucky that Medicare approves to sell Part C plans. We’ll discuss Humana’s plans, their costs, what they cover, and more.
In 2025, Humana will offer Medicare Advantage plans in 48 states and Washington, D.C., and Puerto Rico.
By law, Medicare Advantage plans have to cover at least as much as Original Medicare, so you can be sure you’ll get hospitalization, medical, and preventive care coverage, including annual screening appointments and vaccines.
That said, some plans may offer extra benefits. The exact coverage options and costs vary by geographic area, so a plan your relative in another state is enrolled in might not work for you.
The types of Medicare Advantage plans offered by Humana in 2025 include:
- HMO: Health Maintenance Organization (HMO) plans may cost less while offering extra benefits like dental care, the Silver Sneakers fitness program, and prescription drug coverage. But, you’ll need referrals from your primary care physician (PCP) for specialists.
- PPO: Preferred Provider Organization (PPO) plans give you the freedom to choose any Medicare-approved doctor you wish to see. They offer similar add-ons to HMO plans, but they may cost more. That said, you won’t need a referral to see a specialist.
- PFFS: Private fee-for-service (PFFS) plans are not available everywhere. With these plans, Humana, not Medicare, determines what they pay healthcare providers and hospitals and how much you pay for your care. Confirming that your doctor accepts the plan is important because they may accept payment on a case-by-case basis for non-emergency service.
- SNP: Special Needs Plans (SNPs) usually have no copays, premiums, or coinsurance. But they’re only for those who meet specific eligibility criteria, like living in a nursing home or having a chronic condition approved by Medicare. If you qualify, you get Original Medicare benefits plus Part D and additional health programs like dental, vision, hearing care, and non-emergency transportation.
Starting in 2025 you’ll have a maximum out-of-pocket cap of $2,000 on prescription drugs. Once you reach this limit, you’ll automatically receive “catastrophic coverage.”
This means you won’t have to pay anything out-of-pocket for your covered medications for the remainder of the year. It also eliminates what’s known as the “donut hole.”
Humana offers three types of Part D prescription drug plans. These Part D plans are used to help manage the cost of prescription medications.
- Humana Value Rx Plan (PDP): This plan is ideal if you’re looking for cost-effective coverage of generic drugs. You won’t have a copay for Tier 1 and Tier 2 prescriptions at preferred pharmacies or any deductibles for these drugs.
- Humana Premier Rx Plan (PDP): This is the most comprehensive plan, covering over 3,700 prescription drugs with a $0 deductible.
- Humana Basic Rx Plan (PDP): This plan is a good choice of you qualify for Extra Help, which covers the entire premium. The plan provides basic coverage and access to a preferred mail-order pharmacy.
Humana’s Medicare supplement insurance plans, or Medigap, can help you pay costs that Medicare parts A and B won’t cover. These costs include things like coinsurance, deductibles, and copayments.
Humana offers eight different Medigap plans:
The benefits for each Medigap plan from every insurance company are the same, with only minor differences.
But the company you choose can be very different, and this can affect the quality of service and the price of the plan.
You can compare these offerings against competing insurance companies to get the best price and coverage for you.
Humana Medicare Advantage health plans vary by state and coverage. Some may include prescription drug plans, while others may incorporate additional services, such as dental, hearing, and vision.
You may search for Humana Medicare Advantage plans using Medicare.gov’s plan finder tool. By entering your ZIP code and county, you will see available plans.
Here is a sample of the costs you’ll see with different Humana Medicare Advantage plans across the country in 2021:
| City/plan | Monthly premium | Health plan deductible | Drug plan deductible | Out-of-pocket max | Primary doctor visit | Specialist visit |
|---|---|---|---|---|---|---|
| Portland, OR: Humana Gold Plus H1036-153 (HMO) | $0 | $0 | $100 | $6,750 in network | $0 copay | $40 copay |
| Flagstaff, AZ: Humana USAA Honor Giveback (PPO) | $0 | $0 | $100 | $8,500 in and out-of-network $4,900 in-network | $20 copay | $45 copay |
| Tulsa, OK: Humana Gold Plus H6622-033 (HMO) | $0 | $300 | $200 | $4,200 in network | $0 copay | $30 copay |
| Daytona Beach, FL: Humana USAA Honor Giveback (PPO) | $101 | $0 | $200 | $8,000 in and out-of-network $6,000 in-network | $0 copay | $50 copay |
| Brooklyn, NY: Humana Gold Plus H3533-035 (HMO) | $36.20 | $350 | $400 | $9,350 in network | $0 | $45 |
What are the disadvantages of having a Medicare Advantage plan?
Medicare Advantage (Part C) plans are plans that offer additional coverage over what Original Medicare provides. The costs for each plan vary based on the level of coverage you opt-in for, and your geographic location.
Medicare Advantage plans must legally cover at least as much as original Medicare. Their additional services typically include dental coverage, vision, hearing, and prescription drugs. However, depending on your chosen plan, you may have limited provider options, prior authorization requirements, and additional costs.
What does Humana cover for seniors with Medicare?
As discussed, each Humana Medicare Advantage plan type comes with various extra services above what Original Medicare offers. Here are a few of the coverage benefits many Humana plans offer:
- vision
- dental
- prescription drugs
- home healthcare
- gym memberships or fitness programs
Humana offers a wide range of Medicare Advantage plans throughout most of the country. These plans are required by law to provide at least as much coverage as original Medicare.
Most plans offer more types of coverage, such as vision, dental, and prescription drugs. The plan you can choose must service your ZIP code. Costs vary by plan.