Humana Medicare Advantage Plans Pennsylvania 2025
Discover Humana Medicare Advantage Plans Pennsylvania 2025.
Avoid the uncertainty and learn about plan types, including HMO, PPO, and SNP options, alongside up-to-date information on benefits, costs, and how to enroll.
The right Medicare Advantage plan offers not just healthcare coverage, but peace of mind—our guide outlines the essentials without overwhelming you with jargon or extraneous details.
Key Takeaways
- Humana Medicare Advantage Plans in Pennsylvania offer comprehensive coverage that combines Parts A, B, and often Part D of Medicare with added benefits like vision, dental, and hearing coverage, alongside wellness programs.
- Costs for Humana Medicare Advantage plans in Pennsylvania for 2025 may vary, with projected average monthly premiums for 2025 at $18.50. All plans feature an annual cap on out-of-pocket expenses, providing financial protection for beneficiaries.
- Enrollment in Humana Medicare Advantage plans can be done online or by phone during the Annual Enrollment Period from October 15th to December 7th, with special enrollment periods available for qualifying events.
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Overview of Humana Medicare Advantage in Pennsylvania
Humana, a Medicare-approved private company, offers a diverse selection of Medicare Advantage plans in Pennsylvania. These plans, also known as Part C, combine Part A (hospital insurance) and Part B (medical insurance) and often include Part D (prescription drug coverage) in one plan.
But the magic of Humana Medicare Advantage doesn’t stop there. They also offer additional benefits not typically covered by Original Medicare, such as:
- Vision coverage
- Dental coverage
- Hearing coverage
- Fitness programs
- Over-the-counter allowances
With Humana Medicare Advantage, you can get comprehensive coverage that meets your healthcare needs, including options like Medicare Advantage HMO plans.
Residents of Pennsylvania can choose from three types of Humana Medicare Advantage plans, each designed to cater to different needs: Medicare Advantage HMO PPO, and Special Needs Plans (SNP).
The cost of these plans may vary, with some plans even offering a $0 monthly premium. Regardless of the chosen plan, all beneficiaries enjoy the security of a maximum limit on out-of-pocket expenses, providing peace of mind and financial protection.
Besides standard medical coverage, Humana Medicare Advantage plans in Pennsylvania also include additional benefits. These include coverage for dental, vision, and hearing, along with wellness programs to promote healthy living.
These benefits are designed to provide a well-rounded healthcare solution that goes beyond the traditional coverage provided by Medicare.
Plan Types: HMO, PPO, and SNP
Humana Medicare Advantage in Pennsylvania provides an array of plan types to cater to the distinct healthcare needs of its members. The Health Maintenance Organization (HMO) plans require members to use network providers for their healthcare services, except in emergencies.
This can result in lower out-of-pocket expenses, making it a cost-effective option for many beneficiaries.
For individuals who want more flexibility in their healthcare choices, Humana offers Preferred Provider Organization (PPO) plans. These plans allow members to see any doctor or specialist of their choosing, including those outside the plan network, albeit at a higher cost.
In addition, Humana offers Special Needs Plans (SNP) designed for people with specific diseases, and disability, including those with dual eligible special needs.
These plans tailor their benefits, provider choices, and drug formularies to best meet the specific needs of the groups they serve.
Additional Benefits
Beyond standard coverage, Humana Medicare Advantage plans also provide a wealth of additional benefits. One such added benefit is dental coverage, which includes an annual exam, two complimentary cleanings per year, and dental X-rays once every five years.
Vision coverage is another valuable benefit included in Humana Medicare Advantage plans. It covers routine eye exams and provides allowances for eyeglass frames with prescription lenses or prescription contact lenses.
Moreover, diagnostic hearing and balance exams are covered if they are prescribed by a doctor or healthcare provider, offering some hearing benefits. However, the plans do not include coverage for hearing aids or exams for fitting hearing aids.
In addition to offering Medicare Advantage plans, Humana Medicare Advantage plans also offer wellness initiatives and telehealth services, providing a comprehensive healthcare solution.
Costs and Coverage for Humana Medicare Advantage Plans in Pennsylvania
Grasping the costs tied to Medicare Advantage plans is key to making an informed decision. With Humana Medicare Advantage plans in Pennsylvania, there are several costs to consider.
These include the monthly plan premium, out-of-pocket expenses, and any deductibles or copayments. The projected average monthly plan premium for Humana Medicare Advantage beneficiaries in Pennsylvania for the year 2025 is $18.50.
Humana Medicare Advantage plans are designed with an annual maximum out-of-pocket limit. This means that once this limit is reached, Medicare beneficiaries will not have to pay anything for covered services for the rest of the plan year.
This financial protection can provide peace of mind for members, knowing that their healthcare expenses are capped each year.
Coverage under Humana Medicare Advantage plans is extensive, providing a wide range of covered benefits. These include hospital and medical coverage (Part A and Part B), prescription drug coverage (Part D), and additional benefits such as dental, vision, and hearing coverage.
It’s important to note that specific coverage details may vary depending on the plan chosen.
Premiums and Out-of-Pocket Expenses
The premiums associated with Humana Medicare Advantage plans in Pennsylvania differ, with the projected average premium for 2025 estimated at $18.50 per month.
This is lower than the national projected average, making Humana a cost-effective choice for many Pennsylvania residents seeking comprehensive healthcare coverage.
Alongside monthly premiums, Humana Medicare Advantage plans also include out-of-pocket costs. These can include copayments, coinsurance, and deductibles. However, all Humana plans come with an annual maximum on out-of-pocket expenses.
This means that once a member reaches this limit, they will not have to pay for covered services for the rest of the plan year, offering a safety net for healthcare expenses.
Coverage Details
Humana Medicare Advantage plans, also known as Medicare plans, offer extensive coverage that goes beyond what traditional Medicare provides. In 2025, there will be 36 Medicare Advantage plans with prescription drug coverage available for individual enrollment.
This provides a range of options for individuals seeking comprehensive healthcare coverage. These plans cover a wide range of medications, helping members manage their health conditions while keeping out-of-pocket costs low.
In addition to prescription drug coverage, Humana Medicare Advantage plans also offer the following benefits:
- Dental benefits, including yearly exams, complimentary cleanings, and dental X-rays once every five years
- Vision benefits, offering allowances for frames and lenses every 12 months and for frames every 24 months from the last date of service
- Some plans may also include worldwide emergency care coverage, providing peace of mind for members who travel.
Enrollment Process and Periods
The process of enrolling in a Humana Medicare Advantage plan in Pennsylvania is quite straightforward. It can be completed online through the Humana website or over the phone by calling 1-888-204-4062.
During the enrollment process, applicants will be required to complete an enrollment form, verify their eligibility, and select a plan that aligns with their healthcare needs.
When enrolling, applicants will need to provide certain information, including their date of birth, address, and Medicare number. The Medicare number can be found on the government-issued Medicare card.
Once the form is completed and submitted, applicants will receive confirmation of their enrollment. It is important to note that enrollment is open to all.
Each year, the annual enrollment period for Humana Medicare Advantage plans in Pennsylvania extends from October 15th to December 7th.
During this time, individuals can enroll in a plan, switch plans, or drop their Medicare Advantage plan and return to Original Medicare. There are also special enrollment periods for certain situations, such as moving to a new area or losing other health coverage.
How to Enroll
Those interested in enrolling in a Humana Medicare Advantage plan in Pennsylvania can follow these steps:
- Visit the Humana website.
- Select the ‘Enroll’ button adjacent to your chosen plan.
- Fill out the enrollment form with your personal information.
- Review your application.
- Submit your application.
Alternatively, individuals can also enroll over the phone by calling Humana at 1-888-204-4062 (TTY: 711). Phone lines are open daily, from 8 a.m. to 8 p.m. Eastern time.
This method of enrollment may be particularly helpful for those who are not as comfortable using a computer or have questions about the enrollment process.
Enrollment Periods
The Annual Enrollment Period, also known as the Open Enrollment Period, for Humana Medicare Advantage plans in Pennsylvania runs from October 15th to December 7th.
During this time, individuals can enroll in a plan, switch plans, or drop their Medicare Advantage plan and return to Original Medicare. Changes made during this period will take effect on January 1st of the following year.
In addition to the Annual Enrollment Period, there are also Special Enrollment Periods for certain circumstances. These periods allow individuals to enroll in or switch Medicare Advantage plans outside of the regular enrollment period.
Some of the situations that might qualify an individual for a Special Enrollment Period include moving to a new area, losing other health coverage, or qualifying for Extra Help with Medicare prescription drug costs.
Extra Benefits and Services Offered by Humana Medicare Advantage
Beyond providing standard healthcare coverage, Humana Medicare Advantage plans enhance their offerings with a variety of additional benefits and services.
These value-added features help enhance the overall healthcare experience for members and provide more comprehensive care.
One of these extra services is wellness programs. Humana offers several wellness initiatives like the Humana Healthy Options Allowance and the SilverSneakers fitness program to help members maintain a healthy lifestyle.
These programs offer an array of benefits, including fitness memberships, health coaching, and more.
Humana also provides telehealth services, allowing members to receive healthcare services from the comfort of their own home. These services include virtual visits for medical and behavioral health concerns, making it easier for members to access care when they need it.
In addition, Humana has a network of preferred pharmacies that offer prescription drugs at lower costs, helping members save on their medications.
Wellness Programs
Humana designs its wellness programs to encourage a proactive approach towards health. The Humana Healthy Options Allowance, for instance, gives members access to a variety of health and wellness products and services, including over-the-counter items, personal safety products, and more.
In addition, Humana provides fitness memberships through the SilverSneakers program.
This program offers access to gym memberships, fitness classes, and a network of fitness locations across the country, all at no additional cost. This makes it easy for members to stay active and maintain a healthy lifestyle.
Telehealth Services
With their convenience and accessibility, telehealth services have emerged as an increasingly integral component of healthcare. Humana Medicare Advantage plans provide a range of telehealth services, allowing members to receive medical and behavioral health services remotely.
To access these services, members can:
- Log in to their Humana account
- Schedule a virtual visit
- Connect with a board-certified doctor via a secure video platform
- Receive timely care, even when they can’t visit their doctor in person
All from the comfort of their own homes in rural areas, with the added benefit of free language interpreter services. This not only saves time but also helps ensure that members can receive timely care.
Preferred Pharmacies
Humana collaborates with selected pharmacies to provide preferred cost-sharing. This means that members can enjoy lower copays and reduced out-of-pocket expenses when they fill their prescriptions at these preferred pharmacies.
One such preferred pharmacy is CenterWell Pharmacy™, which is the preferred cost-share pharmacy for the Humana Walmart Value Rx Plan™ and Humana Premier Rx Plan™ in Pennsylvania.
By filling their prescriptions at these lower cost preferred pharmacies, members can maximize their prescription drug coverage and make their healthcare dollars go further.
Comparing Humana Medicare Advantage Plans with Traditional Medicare
Although traditional Medicare provides essential healthcare coverage, it doesn’t encompass all aspects. This is where Humana Medicare Advantage plans come in. These plans offer all the benefits of traditional Medicare, plus additional benefits such as:
- Prescription drug coverage
- Routine vision care
- Routine dental care
- Routine hearing care
Humana Medicare Advantage plans also offer potential cost savings compared to traditional Medicare. They have lower out-of-pocket maximums and often have lower copayments and coinsurance.
In addition, some Humana plans even offer a $0 monthly premium, making them an affordable choice for many individuals.
However, it’s important to note that Humana Medicare Advantage plans may have certain limitations compared to traditional Medicare.
For instance, they may have a more limited network of healthcare providers and may require prior authorization for certain services. Therefore, it’s essential to carefully consider your healthcare needs and preferences when choosing between Humana Medicare Advantage and traditional Medicare.
Costs
In terms of costs, Humana Medicare Advantage plans generally have lower premiums compared to traditional Medicare, including the Medicare Part B premium. The average premium for a Humana plan in Pennsylvania is $27.94 per month, which is lower than the national average.
In addition to premiums, it’s also important to consider out-of-pocket costs. With Humana Medicare Advantage plans, these costs are often lower than with traditional Medicare.
Plus, Humana plans have an out-of-pocket maximum, which means that after you spend a certain amount on healthcare in a year, you won’t have to pay for covered services for the rest of that year.
Coverage and Benefits
Regarding coverage, Humana Medicare Advantage plans extend a broad spectrum of benefits usually not included in traditional Medicare.
These include prescription drug coverage, routine dental, vision, hearing care, and wellness programs. This comprehensive coverage can be a significant advantage for individuals who need these services.
However, it’s important to remember that while Humana Medicare Advantage plans offer additional benefits, they may also come with certain limitations. For example, they may have a more limited network of providers and may require prior authorization for certain services.
As always, it’s crucial to review the specifics of any plan before enrolling to ensure it meets your healthcare needs.
Summary
In summary, Humana Medicare Advantage plans in Pennsylvania provide a comprehensive healthcare solution for individuals eligible for Medicare.
Offering a range of plans, including HMO, PPO, and SNP options, alongside additional benefits such as wellness programs, telehealth services, and preferred pharmacies, they cater to diverse needs.
While they offer potential cost savings and enhanced coverage compared to traditional Medicare, it’s essential to consider individual healthcare needs and preferences when choosing a plan.
Frequently Asked Questions
→ What is new in Humana in 2025?
In 2025, Humana’s Medicare Advantage plans now include dental, vision, and hearing benefits, offering a more comprehensive coverage for members.
→ What is the Humana over the counter allowance for 2025?
The Humana over the counter allowance for 2025 is a $100 quarterly allowance for approved over-the-counter health and wellness products available through their OTC Mail Order provider.
Unused amount expires at the end of the quarter.
→ 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 potential for higher overall costs, especially for complex medical needs.
These plans are more suitable for individuals with less expensive medical requirements.
→ What types of plans does Humana Medicare Advantage offer in Pennsylvania?
Humana Medicare Advantage in Pennsylvania offers Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Special Needs Plans (SNP).
These plans provide a range of options to meet different healthcare needs.
→ What additional benefits do Humana Medicare Advantage plans provide?
Humana Medicare Advantage plans provide additional benefits such as dental, vision, and hearing coverage, wellness programs, and telehealth services.
These plans offer comprehensive coverage beyond basic medical services.
ZRN Health & Financial Services, LLC, a Texas limited liability company
Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.