$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 full release here:
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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.
About Humana
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.
Additional Information
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.
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version on businesswire.com: https://www.businesswire.com/news/home/20221001005004/en/
Kelli LeGaspi Humana Corporate Communications 502-519-5161
Klegaspi1@humana.com
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