How Group Medicare Advantage works
Plan members remain in the Medicare program and continue to pay Medicare-applicable premiums. They simply receive their Medicare benefits through a private insurance company.
Why add Humana Group Medicare Advantage to your portfolio?
Including these products in your portfolio benefits you in many ways.
- Save money for your clients - For many employers, Group Medicare Advantage plans are the most efficient, cost-effective retiree benefits solution. In particular, our network-based plans combine the savings your clients need with the easy-to-use benefits retirees want. But if a network-based plan doesn't address a client's coverage needs completely, consider an alternative plan from Humana's full spectrum of retiree medical solutions.
- Enhance your client service - By representing a broader range of products, you can better serve all your clients' needs.
- Serve more members - With Group Medicare Advantage products, you may be able to continue to serve members when they become eligible for Medicare.
- Simplify administration - Humana's dedicated account management team can help you make the sale and guide customers through implementation. Our account management and direct marketing associates handle all the details - from member meetings to enrollment. We have the capability to supply presentations, enrollment kits, seminars, and in-home appointments. Humana has more than 1,600 agents to work directly with members on education and enrollment.
- Offer more coordinated care - Going beyond coverage and claims processing, Humana's Medicare Advantage plans include services designed to improve members' overall well-being. These services include care coordination for members with chronic or complex conditions, phone-based nurse support, and senior-focused fitness programs.
- An experienced partner - Humana has nearly 25 years of experience serving people with Medicare.
Humana's network-based Group Medicare Advantage plans
In recent years, Humana has expanded our Group Medicare Advantage networks significantly. Humana offers Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO) plans in key areas across the country. A combination of multiple products may be the most efficient solution, offered as a "total replacement" or in conjunction with Medicare secondary options.
Humana offers these network-based plans:
- Local PPO - Allows members to obtain covered services from any provider, but covers a larger portion of costs for services from in-network providers. We offer local PPOs in 423 counties and Puerto Rico.
- Regional PPO - Generally includes the same benefits and services as our local PPO plans, but offers a wider choice of providers from statewide networks. We offer regional PPOs in 23 states.
- HMO - Members work one-on-one with a primary care physician (PCP) who coordinates care and provides referrals to other in-network providers when necessary. PCP referrals aren't required in Alabama, Louisiana, Mississippi, Puerto Rico, or Tennessee. Humana offers Group Medicare Advantage HMOs in 42 local markets and Puerto Rico.
To enroll in this Medicare Advantage plan, retirees and dependents must be enrolled in both Medicare Part A and Part B. Retirees and dependents can enroll in a Medicare Advantage health plan three months before or after their 65th birthday.