A PPO or POS plan with a built-in benefit allowance.

CoverageFirst SM

CoverageFirst SM is a unique Preferred Provider Organization (PPO), Point of Service (POS), or Health Maintenance Organization (HMO) plan design that includes coverage for basic healthcare, plus protection in case of a major unexpected illness or injury.

Not all employees need the same amount of coverage. And with healthcare costs going up, it doesn't make sense for your employees to buy more insurance than they need. The plan includes a "benefit allowance" for each covered member – money that can be used before the member has to meet the deductible. At the other end of the spectrum, CoverageFirst has an out-of-pocket maximum to limit a member's costs in case of a serious illness or injury.

Value for employers and employees

It's likely many of your employees visit the doctor just a few times a year – or less – and have annual medical costs below $500. With CoverageFirst, those employees would pay only copayments and premiums – premiums that are lower than with most traditional health plans.

And since CoverageFirst has a "safety net," even employees who need more medical care can have peace of mind knowing there's a limit on their out-of-pocket costs.

Incentives encourage "smart shopping"

Many CoverageFirst features are designed to promote smart healthcare decisions:

  • The allowance can only be used with in-network providers, which drives members to providers who offer discounts. In addition, CoverageFirst pays a higher coinsurance percentage for in-network providers and has a separate, higher deductible for out-of-network providers.
  • The deductible gives employees a financial incentive to manage their spending as they near the end of their $500 allowance.
  • Copayments ensure that members share in the cost of services during every phase. With CoverageFirst, employees are always responsible for copayments.

CoverageFirst network options

Humana's network offerings for CoverageFirst vary by area. Your options may include:

  • Humana/ChoiceCare ® Network is our nationwide PPO network, with more than 550,000 unique providers and approximately 3,500 hospitals; for more details, visit ChoiceCare Network
  • National POS – Open Access offers improved discounts and a network of providers that overlaps 95 percent with the national Humana/ChoiceCare Network

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Critical Illness

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