There are several different parts of Medicare. Your Plan A is your hospital insurance that will cover any surgeries, lab tests, or inpatient care at a facility. By contrast, Plan B is your clinical insurance, which covers doctors’ visits, outpatient procedures, preventative services, lab tests, and medical equipment. Plan B does not cover routine dental, vision or hearing care, or routine foot care. Medicare Supplement Plan C covers the majority of your Medicare Part A deductible and some of your other out-of-pocket Medicare costs. Also known as Medigap or Medicare Advantage Plans, these Part C plans cover vision, hearing, and dental care, too. Your Part D plan is your prescription drug insurance plan, but your Medigap plan may also reduce some of your out-of-pocket expenses for medications.

More than 33% of Medicare members enroll in Medicare Advantage. In fact, Medicare Advantage enrollment has almost doubled in the last 10 years. This is because, in addition to including all the benefits of original Medicare Parts A and B that Advantage Plans are required to offer by law, they can save beneficiaries money in the long run. It’s the best choice for individuals who know they will need a lot of medical care as they age. The reason is because there is an annual maximum out-of-pocket limit, which in 2020 was $6,700. 

About Humana

Humana was founded in 1961 in Louisville, Kentucky originally as a nursing home operator. Later the company began owning and managing hospitals. The company moved into health insurance in the 1980s and continued growing until it was estimated by Forbes magazine in 2015 to be worth $26.7 billion.

Humana offers the following types of Advantage Plans 

  • Health Maintenance Organization (HMO) 
  • Private Fee-for-Service (PFFS) 
  • Special Needs Plan (SNP)
  • Preferred Provider Organization (PPO) 

Humana Medicare Advantage HMO Plans

A lot of people like the HMO plans because in many zip codes there is a zero dollar monthly premium. The co-pays are also very low, about $30 in most locations. And depending on the plan you choose, your annual deductibles are between $0 and $400. Your annual maximum out-of-pocket costs will also be anywhere from $3,000 to $4,500. However, usually, you will need a referral in order to see a specialist.

Humana Medicare Advantage PPO plans

The PPO plan, by contrast, allows you to choose any Medicare-approved doctor you want to see, and you do not need a referral in order to see a specialist. Your monthly premiums will range between $0 and $200, but in some cases, they could be more. Your co-pays for specialist care will be between $20 and $40.

Humana Medicare Advantage PFFS Plans

The Humana PFFS plans are different because Humana determines what they will pay your healthcare providers and hospitals for your care, as well as how much you will be required to pay for your care, rather than Medicare making that determination. So, it’s important to confirm that your physicians agree to be part of the Humana PFFS network. Doctors that are out-of-network may also accept PFFS plans, or accept them on a case-by-case basis. Your preventative screenings are free and you do not need a referral in order to see a specialist on a PFFS plan. 

Humana Medicare Advantage SNP Plans

SMP plans are generally free and do not have co-pays, coinsurance, or premiums. In order to qualify, you must be living in an institutional setting (such as a nursing home), have a severe or disabling chronic condition, and you must be eligible for both Medicare and Medicaid. At South Florida Medicare Specialists, we can help you determine your eligibility for this plan if you are uncertain.

Why You Should Call South Florida Medicare Specialists

It’s important to speak with a Medicare insurance broker to learn all of the important details about your Medicare plan so that you’re not confused about it later or denied a service you thought that was covered. Our South Florida Medicare Specialists will provide you dedicated assistance in choosing the right plan for you. We will review your different options since they vary per person. Depending on how many years you have been working, you may qualify for free Medicare hospital insurance (Part A) if you are age 65 or older. If you have worked in certain industries there may be other options available to you.

But the other reason you should speak with one of our South Florida Medicare Specialists is that Medicare Advantage Plans are based on where you live. Medicare Part A can be used anywhere that Medicare is accepted. But Medicare Advantage Plans are not. Our South Florida Medicare Specialists can walk you through the many plans available here in West Palm Beach.

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