Benefit and network updates for Humana members

We have received many questions from providers. Our intent is to communicate frequently about changes as they happen and quickly update as additional information emerges. Please check this page regularly for new information. In the event that individual states find themselves facing unique challenges, Humana will work closely with them to help support our members there. See the latest information specific to your state.

2021 Benefits

  1. Humana offers LabCorp at-home COVID-19 testing and has collaborated with Walmart and Quest Diagnostics on drive-thru testing for Humana members.

    Humana has developed an online coronavirus risk-assessment tool to help members navigate COVID-19 testing.

    Members who have symptoms consistent with COVID-19 infection, or those without symptoms who may have been exposed to the virus, qualify for testing and will be given the option to request an in-home test or drive-thru testing.

    Members do not need to consult with a physician prior to completing the risk assessment. The intent of this program is to help members understand their risk for COVID-19 and offer two convenient methods to obtain a test. Throughout our process, we recommend that members contact their primary care physician (PCP) if they have questions or need to be seen in person.

    Read the full press release, opens new window.

    For more information, visit the COVID-19 Testing FAQs.

    Please note: Quest and LabCorp do not collect COVID-19 samples directly from patients. Refer specimens to these labs and do not send patients directly to their patient service centers.


  2. For 2021, Medicare Advantage benefits include no member cost share for in-network telehealth visits for primary care, urgent care and behavioral health.

    Members will have no copays, deductibles or coinsurance for the telehealth visits outlined above. For specialty telehealth visits, please verify member plan benefits as any applicable member cost-share would apply. Please refer to Humana’s COVID-19 Telehealth and Other Virtual Services policy, opens new window, for further information. Medicaid plans will continue to follow state requirements for telehealth services.


  3. For 2021, Medicare Advantage benefits include no member cost share for COVID-19 treatment.

    Members will have no copays, deductibles or coinsurance for covered services for treatment of confirmed cases of COVID-19. Members are encouraged to check their plan documents for details about their 2021 coverage. Medicaid plans will continue to follow state requirements for COVID-19 treatment.


  4. For 2021, Medicare Advantage benefits include no member cost share on covered COVID-19 testing and related services.

    In addition, Humana will waive member cost share in 2021 on COVID-19 testing and related services for Medicare Supplement, fully-insured group commercial and self-insured group commercial plan members during the COVID-19 public health emergency (PHE). Members will have no copays, deductibles or coinsurance for covered COVID-19 testing and related services; this includes laboratory testing, specimen collection and certain related services that result in the ordering or administration of the test, including physician office or emergency department visits. This is limited to the cost share for the coverage provided by the plan, e.g., medical cost only for Medicare Supplement. Medicaid plans will continue to follow state requirements for COVID-19 testing.


  5. Members may have several options for prescription delivery.

    Members may be able to have their prescriptions delivered. Check with CVS, Walgreens and other local pharmacies to see if they offer local prescription delivery to support patients in social isolation. As an alternative, providers can support the movement of member prescriptions to Humana Pharmacy’s 90-day mail order faster by sending orders to Humana Pharmacy®. See HumanaPharmacy.com/prescribers, opens new window for prescribing information. Please keep in mind that first-time setup takes approximately 5 days for processing and delivery after prescription orders are received.


  6. Early prescription refills allowed through Apr. 7, 2021.

    Humana is allowing early refills on prescription medicines for Medicaid members and Medicare members with Part D prescription drug coverage, including both MAPD and PDP members, so they can prepare for extended supply needs—an extra 30- or 90-day supply as appropriate. Does not apply for Medicare Advantage only members.


  7. Hydroxychloroquine, chloroquine and mefloquine to be limited.

    In response to the COVID-19 pandemic, regulatory agencies in several states have taken steps to limit the inappropriate use of medications that may have the potential to be used for patients with the coronavirus. Humana Pharmacy and potentially other pharmacies in our network, opens new window are planning to limit the supply of hydroxychloroquine, chloroquine and mefloquine to preserve the medications for patients who have an established need for them. Please contact pharmacies directly for more information. See Humana Pharmacy’s message, PDF opens new window for more details.


  8. Member support line available.

    Humana has trained a specialized group of call center associates to help support our members with specific coronavirus questions and concerns, including assistance in accessing their telemedicine benefits. Members can call Humana’s toll-free customer support line, which can be found on the back of their member ID card, to be connected to this dedicated team of professionals.


  9. Home oxygen is covered for temporary use.

    Humana is now covering short-term home oxygen usage for members with a COVID-19-related diagnosis.


2020 Benefits

  1. Member cost share for all in-network primary care visits was waived for 2020 to encourage members to seek needed care from their primary care physician.

    This applied to Humana Medicare Advantage members. Cost share waivers were retroactively effective as of May 1, 2020. These cost-share waivers applied to office visits for all participating/in-network providers as well as any labs performed in the PCP’s office during the visit. Labs drawn in the PCP’s office and sent to a hospital or reference lab were excluded from the primary care cost-share waiver, as are radiology, supplies and Medicare Part B drugs administered as part of the visit.


  2. Member cost share for outpatient behavioral health visits was waived for 2020 to encourage members to seek needed behavioral health care.

    This applied to Humana Medicare Advantage members. We waived all member cost share on outpatient, non-facility-based behavioral health visits with participating/in-network providers. This included psychiatric medication consults, individual therapy and group therapy. These cost-share waivers were retroactively effective as of May 1, 2020.


  3. Member cost share for in-network telehealth visits was waived for 2020 to give members flexibility to seek and receive care.

    This applied to Humana Medicare Advantage, fully-insured group commercial, and some self-insured group commercial members. This waiver applied to telehealth visits with all participating/in-network providers, including primary care, behavioral health and other specialist providers. These cost-share waivers were retroactively effective as of March 6, 2020. Medicaid plans followed state requirements for telehealth services.


  4. Member cost share on covered COVID-19-related testing was waived for 2020.

    This applied to Humana Medicare Advantage, Medicare Supplement, fully-insured group commercial and self-insured group commercial members. This applied to COVID-19 testing and related services, including laboratory testing, specimen collection and certain related services that result in the ordering or administration of the test, including physician office or emergency department visits. This was limited to the cost share for the coverage provided by the plan, e.g., medical cost only for Medicare Supplement. This cost-share waiver applied on a retroactive basis to services delivered on or after Feb. 4, 2020. Medicaid plans followed state requirements for COVID-19 testing.


  5. Member cost for COVID-19 treatment was waived for some members in 2020.

    This applied to Humana Medicare Advantage, Medicare Supplement, fully-insured group commercial, and some self-insured group commercial members. Eligible members had no copays, deductibles or coinsurance for covered services for treatment of confirmed cases of COVID-19. This was limited to the cost share for the coverage provided by the plan, e.g., medical cost only for Medicare Supplement. This cost-share waiver applied on a retroactive basis to services delivered on or after Feb. 4, 2020. Medicaid plans followed state requirements for COVID-19 treatment.