Humana Simplicity

With these plans, there are no in-network deductibles or coinsurance—only copayments for certain healthcare services. Humana Simplicity is a straightforward medical copayment plan with no in-network deductible. It’s easy to understand and use.

  • Predictable copayments – By using in-network doctors, employees know their copayment costs up front, which helps them decide the level of care they want to use. And they only make one copayment per day regardless of the number of services performed, not counting facility charges.
  • Prescription coverage – Once employees reach their annual out-of-pocket maximum for medical services, the plan will cover 100% of all subsequent services and prescriptions.
  • No deductibles to track – Whatever option they choose, employees will enjoy any one of three-tiered copayment options that count toward maximum out-of-pocket expenses, not deductibles that must be met first.
  • Vital benefits – Employees have full access to HumanaVitality, which encourages them to set healthy goals for themselves and their families. As they take steps to quit smoking, eat healthier and maintain a healthy lifestyle, they can earn Vitality Bucks® to spend on well-deserved rewards. https://www.humana.com/employer/products-services/wellness-programs/humanavitality

    Simplicity: HMO

    Health maintenance organization (HMO) plan members enjoy a large network and lower premiums. For small businesses, HMO Premier is the largest Humana HMO network available, and it offers the lowest premiums of any Humana Simplicity plan.

    Simplicity: POS

    National point of service (POS) plan members are free to go to any doctor, but can keep their costs low by staying within the network. For small businesses, the National POS—Open Access plan offers improved discounts and a network of medical professionals that overlaps 95% with the national Humana/ChoiceCare® Network.

    Simplicity: PPO

    Preferred provider organization (PPO) plan members have the flexibility to go to their choice of doctors—no referrals needed. For small businesses, our ChoiceCare network has more than 550,000 unique medical professionals and approximately 3,500 hospitals nationwide. For larger companies, choose from one of three standard copayment structures for your employees.

    Key features:

    • Medical expenses are paid at 100% of the eligible charges once the out-of-pocket maximum has been reached.
    • Preventive care services are covered at 100% for in-network providers.

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