Legal information for Medicare Advantage, Medicare Supplement and Medicare prescription drug plans

Legal disclaimers

This website is for individual Medicare coverage only.

Humana is a Medicare Advantage HMO, PPO and PFFS organization and a stand-alone prescription drug plan with a Medicare contract. Humana is also a Coordinated Care plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in any Humana plan depends on contract renewal.

If your plan has a network

You must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis. If you obtain routine care from out-of-network providers neither Medicare nor Humana will be responsible for the costs.

For PPO plans

With the exception of emergency or urgent care, it will cost more to get care from out-of-network providers. Additionally, accessing services from in-network providers can cost less than using services of out-of-network providers.

If benefits for which the coinsurance percentage is the same both in and out of network, member responsibility will be greater out of network when the out-of-network coinsurance is based on the Medicare allowed amount and the contracted amount is lower.

The plan provides reimbursement for all covered benefits regardless of whether they are received in network, as long as they are medically necessary.

Legal information for Medicare Supplement plans

Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and in some states to those under age 65 eligible for Medicare due to disability or End Stage Renal disease.

Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.

It should be noted that Medicare Supplement plans are not managed care.