$0 premiums, dental and Rx benefit enhancements, new allowances, a USAA co-branded plan, and simplified access to prescriptions offer more options for beneficiaries
Humana Inc. (NYSE: HUM) today released details of its Medicare Advantage and Medicare Prescription Drug Plan offerings for 2023 – with a clear focus on benefits and support based on what its members have said they want and need.
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The news comes after the company’s pledge earlier this year to identify $1 billion in cost savings to invest back into its Medicare Advantage program and CenterWell healthcare services.
Humana – ranked No. 1 among health insurers for customer experience quality in Forrester’s proprietary 2022 U.S. Customer Experience Benchmark survey – is offering a wide range of cost-effective and flexible plans to meet the diverse needs of millions of Medicare-eligible individuals during the Annual Election Period Oct. 15-Dec. 7.
“When you sum up what Humana is offering this year, it’s as simple as this: Our members spoke, and we listened,” said George Renaudin, Medicare President for Humana. “We conducted extensive research to ensure our changes align with consumer wants and needs. This research resulted in investments focused on what consumers want, like dental coverage, which is consistently a #1 priority in supplemental benefits for our members.”
Humana’s goal as it designed plans for 2023 was to ensure benefit stability or improvement for current Humana members. Humana will also expand Medicare HMO offerings into 260 new counties and introduce Medicare LPPO plans in 260 new counties – marking a significant opportunity to serve an additional 4.6 million Medicare-eligible individuals across the country. This includes plans to expand its Dual Eligible Special Needs Plans (D-SNPs) to 184 new counties. For the first time, LPPO plans will be available in California, Rhode Island and Wyoming, and D-SNPs are being added in South Dakota, Wisconsin and Wyoming.
MEDICARE ADVANTAGE (PART C)
Medicare Advantage plans combine the benefits of original Medicare and may include other options, like dental, vision, hearing and prescription drugs. Original Medicare includes hospital insurance (Part A, which is free for individuals eligible for Medicare who have paid payroll taxes for at least 10 years) and medical insurance (Part B, which has a premium and deductible, and requires copays for many services). Medicare Advantage covers Parts A and B in addition to other health and wellness benefits and services, such as routine dental, vision and hearing care on many plans, and often includes Medicare prescription drug coverage (Part D).
Many Humana Medicare Advantage plans also include predictable copayments and no deductibles for many services, maximum out-of-pocket protection, and innovative offerings such as fitness programs, flexible spending accounts and transportation benefits.
Humana’s 2023 Medicare Advantage Updates
- More $0 premium offerings. Humana is significantly increasing the availability of $0 premium HMO and LPPO plans to improve affordability, accessibility and ease of use.
- Healthy Options Allowance. The new Healthy Options Allowance offers members with D-SNPs, and other qualifying members with chronic health conditions on some Medicare Advantage plans, the flexibility to spend their funds – up to $3,300 a year depending on the plan – where they need it most – whether that’s for groceries, rent and utilities, over-the-counter products, home supplies, non-medical transport, pest control, pet care supplies, disaster relief kits, and more.
- $0 Rx copays. For individuals eligible for Medicare and Medicaid, Humana’s D-SNPs come with $0 Rx copays on all covered Part D prescriptions.
- Enhanced dental benefits. An out-of-network benefit for dental is being added to certain HMO plans to offer improved access to providers. There are also options for embedded dental, including allowances of $500 or more. Members can use the allowance toward covered services, without limits on the number of individual services, like extractions or number of cleanings. The new allowances can be used toward all covered dental services at 100 percent up to the allowance amount and allow members to go to any dental provider in or out of network on PPO options.
- Flexible allowance for dental, vision and hearing. The flexible annual allowance on certain plans helps members pay out-of-pocket dental, vision or hearing expenses for covered services, making them more affordable for members.
- Simplified access to prescription medications. Humana is removing the preferred retail pharmacy pricing to create one robust retail network with more than 60,000 pharmacies that will offer the same low-cost access to prescription drugs. Many plans include low to no cost sharing for commonly used generics and maintenance medications to ensure members can afford the medications they need.
- Enhanced vaccine and insulin coverage. All Medicare Advantage Prescription Drug plans will offer $0 Part D vaccines, including the shingles vaccine, while COVID-19 and flu vaccines will remain covered at $0. Member cost share of covered Part D insulin will be no more than $35 for every one-month (up to a 30-day) supply.
- Veteran-focused plans with option to include prescription drugs and givebacks. Humana and USAA partnered to design the new Humana USAA Honor with Rx plan. Like all Humana Honor plans recommended by USAA, the new plan is available to anyone eligible for Medicare but may be an especially good fit for veterans, as it complements and works alongside their VA healthcare benefits. It is designed to give veterans more flexibility to choose between the VA or civilian doctors, pharmacies and specialists. Benefits of the Humana USAA Honor with Rx plan include $0 premiums, Part B giveback ranging from $40-75 a month depending on the plan, preventive and robust dental coverage with an additional $1,000 allowance, and prescription drug options that offer access to medications at local pharmacies with co-pays as low as $0. Humana and USAA together will also offer the USAA Health Flex Card to cover out-of-pocket expenses for covered dental, vision and hearing care.
- Expanded hospital services at home with $0 cost share. Humana is significantly expanding support for its two hospital-at-home models. Both the provider-referred model and the facility-referred model include a $0 cost share on some plans.
- HMO travel benefit offers care coverage when outside the home area. HMO Open Access plan members will be able to seek non-emergency services from contracted HMO providers when traveling to other states.
- Social support for members experiencing loneliness. Papa Pals is a social needs benefit on select plans that provides qualifying members with companionship and general support up to eight hours per month. College students are matched with members to assist with light housekeeping, transportation to doctor appointments, grocery shopping, and even use of computers and smartphones.
- CenterWell primary care, pharmacy and home health. Humana has expanded its owned clinical care providers to better serve its medical members and strengthen its healthcare services. CenterWell, part of Humana Inc., and in-network with many Humana Medicare Advantage plans, offers primary care, pharmacy and home health services that put patients at the center with personal, comprehensive and accessible care.
MEDICARE PART D (PRESCRIPTION DRUG PLANS)
Original Medicare doesn’t cover most prescription drugs, so individuals who enroll in original Medicare need to sign up for a stand-alone prescription drug plan through a private insurer, like Humana, to cover medications. Adding a Prescription Drug Plan (PDP) to original Medicare or a Medicare Supplement plan offers an important layer of protection against high healthcare costs. Updates to Humana PDP plans include:
- Affordable member cost sharing. PDP plans offer $0 copays for many commonly prescribed medications and a curated network of retail and mail-order pharmacies that offer preferred cost-sharing, including Walmart, Sam’s Club and several grocery chains. Plus, covered vaccines at $0 copay and covered insulins at no more than $35 for every one-month (up to a 30-day) supply.
- Humana Walmart Value Rx. In partnership with Walmart, Humana will continue to offer the Humana Walmart Value Rx plan with an affordable premium that also features affordable copays and access to a preferred cost-sharing network.
- Humana Premier Rx. Humana’s most comprehensive drug plan features several improvements in coverage and benefits, such as 3,700 medications covered on the formulary, including 900 medications covered on Tier 1 & Tier 2 (with a $0 deductible); select insulins as low as $20; and gap coverage for tier 1 and tier 2 medications.
MEDICARE SUPPLEMENT INSURANCE (MEDIGAP)
A Medicare Supplement Policy, offered by Humana for individuals who prefer original Medicare, can help pay some of the health care costs (“gaps”) original Medicare Parts A and B do not pay, such as deductibles, copayments and coinsurance. After Medicare pays its share of the approved amount for covered health care costs, the Medicare Supplement Policy pays its share of covered benefits. There are no provider networks with Medicare Supplement Insurance plans, and the policies are guaranteed renewable with no changes to benefits year to year.
- Freedom of choice. A Medicare Supplement Insurance policy gives individuals the freedom to visit any of the nearly 700,000 medical providers or facilities that accept Medicare patients anywhere in the country. There are no referral requirements or pre-authorization of services to visit specialist doctors. Medicare Supplement plans are standardized, so coverage remains the same even if the beneficiary moves to a new state.
- Household discount. Some Humana Medicare Supplement policies will apply a premium discount for members who might live with another adult or have two Humana policies in the same household.
- Value-added benefits. Many Humana Medicare Supplement policies come with services/discounts such as discounts on vision and hearing services, prescription drug discounts, HumanaFirst Nurse Advice Line, meal delivery following an inpatient stay, and SilverSneakers membership.
Multicultural support. Humana is investing in multicultural experiences to support varying cultural norms around healthcare. With in-language providers and in-language physician finders, sales agents fluent in multiple languages, enrollment books and webpages available in Spanish, Korean and Chinese, Humana is focused on connecting with beneficiaries in the language in which they will best understand their options to make an informed decision about their healthcare.
For More Information. Humana offers in-person, online, telephone enrollment options. All enrollment options will connect Medicare beneficiaries with a licensed sales agent. Visit www.Humana.com/Medicare or call toll-free 1- 888-372-2614 (TTY: 711). Licensed sales agents are available 8 a.m. to 8 p.m. local time, seven days a week.
Humana has served Medicare beneficiaries for nearly 40 years, with nearly 8.7 million Medicare members in all 50 states, Washington, D.C., and Puerto Rico, as of June 30, 2022. Nearly 5.1 million of those members are enrolled in a Medicare Advantage plan.
Humana Inc. is committed to helping our millions of medical and specialty members achieve their best health. Our successful history in care delivery and health plan administration is helping us create a new kind of integrated care with the power to improve health and well-being and lower costs. Our efforts are leading to a better quality of life for people with Medicare, families, individuals, military service personnel, and communities at large.
To accomplish that, we support physicians and other health care professionals as they work to deliver the right care in the right place for their patients, our members. Our range of clinical capabilities, resources and tools – such as in-home care, behavioral health, pharmacy services, data analytics and wellness solutions – combine to produce a simplified experience with the goal of making health care easier to navigate and more effective.
More information regarding Humana is available to investors via the Investor Relations page of the company’s website at humana.com, including copies of:
- Annual reports to stockholders
- Securities and Exchange Commission filings
- Most recent investor conference presentations
- Quarterly earnings news releases and conference calls
- Calendar of events
- Corporate Governance information
About Medicare Advantage
Medicare Advantage delivers financial savings to members in the form of lower out-of-pocket costs and reduced premiums. Medicare Advantage members reported spending nearly $2,000 less on out-of-pocket costs, compared to fee-for-service Medicare. Medicare Advantage plans also have limits on out-of-pocket costs. These financial protections may be critical for older Americans on fixed incomes.
Unlike fee-for-service Medicare, Medicare Advantage plans often include affordable prescription drug coverage. For Humana members, 100 percent of the savings achieved through manufacturer rebates and discounts in pharmacy programs are returned to members through lower premiums and improved benefits.
Medicare Advantage plan members had more than a 30 percent lower level of emergency room visits, and 40 percent lower level of inpatient hospital care, compared to beneficiaries with fee-for-service Medicare. In addition to improving health, these outcomes demonstrate real savings for people with Medicare and the health system. Medicare Advantage plans reinvest these savings by expanding supplemental benefits, supporting providers and coordinating care.
Humana is a Medicare Advantage HMO and PPO organization with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. Other providers are available in the Humana network. Allowance amounts cannot be combined with other benefit allowances. Limitations and restrictions may apply.
The Humana USAA Honor with Rx plan is available to anyone eligible for Medicare and veterans should consider all of their health plan options.
The Humana Prescription Drug Plan (PDP) pharmacy network includes limited lower-cost, preferred pharmacies in urban areas of CT, DE, IA, MA, MD, ME, MI, MN, MO, MS, MT, ND, NH, NJ, NY, PA, RI, SD, WY; suburban areas of CA, CT, DE, HI, IL, MA, MD, ME, MN, MT, ND, NH, NJ, NY, PA, PR, RI, VT, WV; and rural areas of AK, IA, MN, MT, ND, NE, SD, VT, WY. There are an extremely limited number of preferred cost share pharmacies in urban areas in the following states: DE, MA, ME, MN, MS, ND, NY; suburban areas of: MT and ND; and rural areas of: ND. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call Customer Care at 1-800-281-6918 (TTY: 711) or consult the online pharmacy directory at Humana.com.
Humana received the highest CX Index™ score among health insurers in Forrester’s proprietary 2022 Customer Experience Benchmark Survey. The ranking was based on responses from 12,985 US individuals measuring 17 brands in the industry. The proprietary survey results are based on consumers’ opinions of the experiences with the brands in the survey. Forrester Research does not endorse any company included in any CX Index™ report and does not advise any person to select the products or services of any particular company based on the ratings included in such reports.
Humana Corporate Communications