Q. Does Humana offer a Medicare Employer Private-Fee-for-Service (PFFS) plan?
Yes. But for 2010 and beyond, Humana is encouraging our customers to select network-based plans instead. The reason is the Medicare Improvements for Patients and Providers Act of 2008 - commonly known as "MIPPA." Among other requirements, this measure mandates Group Medicare Advantage plans to be provided exclusively through network-based products for 2011.
Rather than create networks for Employer PFFS plans, Humana chose to:
- Expand our existing network plan offerings - We've added PPO networks across the country. Because of these network-development efforts, we now can serve the majority of our members with network-based plans. For those outside of our core markets, we offer various options such as secondary coverage.
- Develop new plan designs - To help customers transition members to network-based plans, we've created new PPO plan options. With these plans, benefit levels are the same in- and out-of-network, similar to a PFFS plan. That means your clients can shift to network-based coverage gradually, without significant benefits changes or disruption to provider access.
For more details, see Medicare Advantage