Humana Medicare Advantage Plans Georgia 2025
In the realm of health insurance, navigating the myriad of options can often feel like traversing a labyrinth. This is especially true when it comes to Medicare Advantage plans, a key pillar of health coverage for millions of Americans.
If you’re a Georgia resident considering such a plan, Humana Medicare Advantage plans Georgia 2025, a leading health insurance provider, offers a range of options tailored to diverse needs.
Key Takeaways
- Humana provides a variety of Medicare Advantage plans in Georgia, including HMO, PPO, and PFFS options, offering additional benefits like prescription drug coverage, and dental, vision, and wellness programs.
- Cost considerations for Humana’s Medicare Advantage plans in Georgia include monthly premiums averaging at $16.50, copays, deductibles, and out-of-pocket maximums, with $0 premium plans available that may have other associated costs.
- Enrollment in Humana Medicare Advantage plans in Georgia is available during the Initial Coverage Election Period or Open Enrollment Period, and requires documentation such as a Medicare card, proof of Georgia residency, and U.S. citizenship or legal residency status.
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Understanding Humana Medicare Advantage Plans in Georgia
As a Medicare beneficiary, you may have encountered the term ‘Medicare Advantage’ in your pursuit of understanding healthcare options. Medicare Advantage plans, also known as Part C, are an alternative to Original Medicare, offering additional benefits such as prescription drug coverage and dental and vision care.
One popular type of these plans is the Medicare Advantage HMO. Humana, a top-rated provider with the highest percentage of members in 4+ star Medicare contracts, offers various Medicare Advantage plans in Georgia that go beyond the scope of Original Medicare, thanks to their Medicare contract.
Getting a solid grasp of the details of these plans, including different types, notable features, and associated costs, is key to deciding that best suits your healthcare needs.
Humana offers a variety of solutions, whether you’re looking for extensive coverage or a plan with more affordable premiums, that address your distinct needs. Your choice of a Humana plan depends on your requirements and preferences.
Types of Humana Medicare Advantage Plans
Humana offers a diverse selection of Medicare Advantage plans in Georgia, providing beneficiaries with a variety of choices tailored to their unique needs. You can select from:
- Health Maintenance Organization (HMO) plans, which require the selection of a primary care physician and referrals for specialist consultations
- Preferred Provider Organization (PPO) plans that offer increased flexibility in selecting healthcare providers
- Private Fee-for-Service (PFFS) plans, which allow beneficiaries to consult any Medicare-approved provider.
Each of these plan types comes with its own unique features and coverage. For instance, Humana’s HMO plan requires the selection of a primary care physician and referrals for specialist consultations while offering dental coverage.
On the other hand, PPO plans offer increased flexibility with a range of in-network providers and access to Humana’s extensive network.
Lastly, PFFS plans, which are a type of PFFS organization, enable beneficiaries to access any Medicare-approved provider without network limitations or referrals. The right choice depends on your healthcare needs, lifestyle, and the level of flexibility you desire in selecting healthcare providers.
Key Features of Humana Plans
Humana’s Medicare Advantage plans stand out due to their comprehensive coverage and additional benefits.
These plans provide a range of prescription drug coverage options, allowing members to access detailed information about their coverage through a summary or by logging in to MyHumana. This coverage is offered by the Humana Insurance Company to beneficiaries in Georgia.
Beyond prescription drug coverage, Humana’s plans feature the following benefits offered by Humana Insurance Services:
- Dental benefits include annual check-ups, two free cleanings per year, and dental X-rays every five years
- Annual eye exams, eyeglass frames with prescription lenses, and prescription contact lenses as part of the vision benefits
- Wellness programs such as the SilverSneakers fitness program and the Go365 well-being & rewards program, offer incentives for healthy behaviors and maintaining strong communication with all members
Comparing Humana’s Top-Rated Medicare Advantage Plans in Georgia
When choosing a Medicare Advantage plan, considering the plan’s quality and performance is a significant factor.
The Centers for Medicare and Medicaid Services (CMS) assess Medicare Advantage plans based on several quality measures and assign them a star rating. Humana offers several 4.5-star and 4-star plans in Georgia, providing beneficiaries with top-rated options for their healthcare needs.
The 4.5-star Humana plan, such as H5216-279-000 and Humana Care Extra (PPO), offers a range of benefits, including Centerwell health care services, wellness and health care planning, reduced cost-sharing, rewards, and prescription drug coverage (Part D).
Conversely, the 4-star Medicare Advantage HMO PPO plans, like the Humana Gold Plus HMO and HumanaChoice PPO, provide comprehensive coverage, additional benefits, and cost-effectiveness.
4.5-Star Humana Plans
The 4.5-star Humana Medicare Advantage Plans available in Georgia, such as H5216-279-000 and Humana Care Extra (PPO), encompass a wide range of benefits.
These plans provide innovative features like wellness and health care planning, reduced cost-sharing, and rewards. Additionally, they offer prescription drug coverage, allowing beneficiaries to access their medications at an affordable price.
These plans stand out due to their superior quality and performance. They have received high ratings from Medicare and provide extra benefits such as improved customer experience, cost-effectiveness, and overall satisfaction.
Furthermore, they offer exclusive programs and features, including dental, vision, and hearing coverage.
4-Star Humana Plans
Humana’s 4-star Medicare Advantage Plans offered in Georgia include:
- Humana Gold Plus HMO
- HumanaChoice PPO
- Humana Gold Choice PFFS
- Humana Honor PPO
These plans provide comprehensive coverage and additional benefits such as dental, vision, and hearing coverage, high-quality ratings, and extensive accessibility, all while putting health first.
These plans stand out due to their high ratings from the CMS, signifying a superior level of quality and performance. The plans offer a range of benefits and are particularly suitable for individuals seeking comprehensive coverage at an affordable price.
Costs and Coverage of Humana Medicare Advantage Plans
One of the key aspects to consider when choosing a Medicare Advantage plan is its cost. The expenses associated with Humana Medicare Advantage Plans in Georgia include:
- Premiums
- Co-pays
- Deductibles
- Coinsurance
- Out-of-pocket maximums
The average monthly premium for a Medicare Advantage plan in Georgia in 2025 is $16.50, which is lower than the projected national average premium.
These costs can significantly impact on your out-of-pocket expenses and should be carefully considered when choosing a plan.
It’s also important to remember that these costs can vary depending on the selected plan, the extent of coverage, and your individual healthcare needs.
Premiums
The average premium for Humana Medicare Advantage Plans in Georgia is $16.50 per month in 2025, which is lower than the projected national average premium of $18.50 per month. This makes Humana’s plans an affordable option for many beneficiaries.
Humana also offers $0-premium Medicare Advantage plans in Georgia. These plans encompass Medicare Parts A and B coverage, along with additional benefits such as dental, vision, and hearing care.
However, it’s important to note that despite the $0 monthly premium, there could still be additional expenses such as co-payments, deductibles, and coinsurance for specific services.
Co-pays and Deductibles
Co-payments, or co-pays, are predetermined costs that members are responsible for when accessing healthcare services. These can include:
- Preventive exams
- Telemedicine
- Pharmacy services
- Virtual visits
The exact co-payment amount varies depending on the specific plan.
Another important cost to consider is the deductible, which is the amount you must pay for healthcare services before your insurance plan starts to pay.
Coinsurance, on the other hand, is a form of cost-sharing where both you and the insurance company divide the expenses of covered services. The specific percentage of coinsurance and its application can differ by plan.
Out-of-Pocket Maximums
The out-of-pocket maximum for Humana Medicare Advantage Plans in Georgia varies based on the specific plan, with a range of $6,100 to $8,300 per year.
This represents the maximum amount that individuals must pay for covered services within a year. Once this limit is reached, covered services are offered at no additional cost for the remainder of the year.
Prescription drug expenses are factored into the out-of-pocket maximum for Humana Medicare Advantage plans, thereby contributing to the threshold beyond which no additional payments are needed for covered drugs for the remainder of the plan year.
It’s important to carefully consider these costs when comparing and selecting a plan, including the availability of lower-cost preferred pharmacies.
Network and Provider Options for Humana Medicare Advantage Members
In the realm of healthcare services, the selection of providers is of substantial importance. Humana Medicare Advantage plans in Georgia offer a provider network that comprises participating or preferred healthcare providers, such as family doctors or primary care physicians (PCPs).
In-network providers typically offer services at reduced costs compared to out-of-network physicians.
Humana’s PPO plans provide the flexibility to access healthcare professionals both within and outside the provider network.
However, it’s important to note that out-of-network providers, who lack a contract with Humana, may result in elevated out-of-pocket expenses for members.
In-Network Providers
Utilizing in-network providers for Humana Medicare Advantage plans guarantees that healthcare services are received at reduced out-of-pocket expenses, as these providers have established pricing agreements with Humana.
You can locate specific doctors or specialists who are part of the in-network provider list in Georgia using Humana’s online search tool.
You can also access a comprehensive list of in-network hospitals for Humana Medicare Advantage plans in Georgia through the online searchable directory provided on the official Humana website.
This tool enables you to search for doctors based on location, provider type, or name, ensuring that you have all the information needed to make an informed decision.
Out-of-Network Providers
An out-of-network provider in Humana Medicare Advantage plans in Georgia is defined as a healthcare provider or facility that has not entered a contract with Humana.
While these providers may not be part of the Humana network, the plan offers coverage for out-of-network providers, allowing beneficiaries to visit any Medicare-approved doctor.
However, seeking care from an out-of-network healthcare provider can result in higher out-of-pocket expenses compared to other providers. Out-of-network providers may also have the authorization to invoice you for the disparity between the amount your plan has agreed to cover, and the total cost of the services rendered.
Despite these potential additional costs, Humana Medicare Advantage plans provide coverage for emergency services from out-of-network providers and will directly pay out-of-network providers and facilities for these services.
Enrollment Tips for Humana Medicare Advantage Plans in Georgia
If you’ve decided that a Humana Medicare Advantage plan aligns with your healthcare needs, the subsequent step is to proceed with enrollment.
Enrollment for a Humana Medicare Advantage Plan is possible during the Initial Coverage Election Period (ICEP), which commences three months prior to your enrollment in both Medicare Parts A and B, as well as the Open Enrollment Period (OEP) from January 1 to March 31.
When enrolling, you’ll need to provide certain documentation, including:
- Your Medicare card
- Proof of residency in Georgia
- Proof of color national origin age
- Proof of U.S. citizenship or legal residency status
- Any additional documents requested by Humana
The enrollment process, which includes contract renewal, can be initiated online through the Humana website.
Eligibility Requirements
To enroll in Humana Medicare Advantage Plans in Georgia, specific criteria must be met. These include being enrolled in both Medicare Parts A and B. Additionally, eligibility is not limited to U.S. citizens. If you’re under 65 and have a disability, you may also be eligible for Medicare.
Certain plans may have additional eligibility requirements, such as national origin, age, disability, and other factors.
For instance, for dual-eligible Special Needs Plans (D-SNPs), eligibility for both Medicare and Medicaid is necessary, while Chronic-Condition Special Needs Plans (C-SNPs) require a qualifying health condition confirmed by a doctor.
Enrollment Periods
The Initial Enrollment Period for Humana Medicare Advantage Plans in Georgia usually occurs from January 1st to March 31st, aligning with the individual’s initial eligibility for Medicare. During this period, individuals have the option to:
- Enroll in a Medicare Advantage plan for the first time
- Switch from Original Medicare to a Medicare Advantage plan
- Change from one Medicare Advantage plan to another
- Modify their prescription drug coverage
In addition to the Initial Enrollment Period, the Annual Enrollment Period for Humana Medicare Advantage Plans in Georgia occurs annually from October 15th to December 7th.
During this time, individuals can enroll in, switch, or disenroll from Medicare Advantage plans. Additionally, Special Enrollment Periods may occur due to life events, permitting enrollment or plan changes outside the standard enrollment periods.
Georgia Medicare Resources and Assistance
Beyond Humana, numerous resources and aid programs exist for Medicare beneficiaries in Georgia, including those that have served Medicare beneficiaries in the past.
The Georgia Department of Human Services offers information for Specified Low-Income Medicare Beneficiaries (SLMB). Individuals can apply for the Medicare Savings Program in Georgia through the Georgia Department of Community Health.
The State Health Insurance Assistance Program (SHIP) in Georgia also offers Medicare assistance to residents of the state.
For further information and assistance, individuals can reach out to the program at 1-800-656-2298. Additionally, the Georgia Department of Human Services can be contacted for general inquiries about Medicare in Georgia.
Summary
Navigating the world of Medicare Advantage plans can certainly seem overwhelming. However, with the right knowledge and resources, you can make an informed decision that aligns with your healthcare needs.
Humana’s Medicare Advantage plans in Georgia offer a wide range of options, from HMO to PPO, and PFFS plans, each with unique features and benefits. Whether you’re seeking comprehensive coverage or a plan with lower premiums, Humana has a solution tailored to your needs.
Remember, the choice of a plan is just as important as the care you receive. Choose wisely!
Frequently Asked Questions
→ What is new in Humana in 2025?
In 2025, Humana introduced dental, vision, and hearing benefits to all Medicare Advantage plans, offering more comprehensive coverage options.
→ What is the best Medicare Advantage plan for 2025?
The best Medicare Advantage plan for 2025 is offered by Humana, known for its high-quality ratings, good customer satisfaction, widespread availability, and numerous $0-per-month plans.
Customers report receiving better quality health care compared to AARP/UHC.
→ What is the Humana over-the-counter allowance for 2025?
Humana’s over-the-counter allowance for 2025 is a $100 quarterly allowance for purchasing approved health and wellness products through their OTC mail-order provider, with any unused amount expiring at the end of the quarter.
There is also a $0 copay for plan-approved transportation up to 36 one-way trips per year.
→ What are the disadvantages of Humana Medicare Advantage?
The disadvantages of Humana Medicare Advantage include a more limited choice of doctors and medical offices compared to Original Medicare, and potentially higher overall costs for complex medical needs.
These plans are more suitable for individuals with less expensive healthcare requirements.
→ What types of Medicare Advantage Plans does Humana offer in Georgia?
In Georgia, Humana offers HMO, PPO, and PFFS plans. These are the types of Medicare Advantage Plans available in the state.
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