Humana Medicare Advantage Plans Rhode Island 2025
The world of healthcare may be complex, especially when it comes to navigating the various Medicare plans available to you.
If you’re a Rhode Island resident looking for a reliable Medicare Advantage plan, Humana likely has got you covered. Potentially offering a diverse range of plans with extensive coverage, Humana is a trusted name in the healthcare industry.
But, with so many options available, how do you select the one that’s just right for you? Well, that’s where this guide comes in.
We’ll take you through the potential ins and outs of some of the Humana Medicare Advantage plans in Rhode Island for 2025, possibly offering you valuable insights into some of their types, potential features, ratings, and more.
Key Takeaways
- Humana offers Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Private Fee-for-Service (PFFS) Medicare Advantage plans in Rhode Island for 2025, which could potentially cover more than the Original Medicare and may often include dental, vision, hearing, and prescription drug coverage.
- A majority of Humana’s Medicare Advantage plans in Rhode Island are highly rated, with about 94% of its Medicare Advantage members enrolled in plans rated 4 stars or above by CMS and potentially offering features like lower-cost preferred pharmacies for prescription drugs in some areas.
- Eligibility for Humana Medicare Advantage plans requires being at least 65 years old and enrolled in both Medicare Parts A and B and residents can enroll during the initial enrollment period around their 65th birthday or during the annual fall open enrollment period from October 15 to December 7.
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Potential Humana Medicare Advantage Plans in Rhode Island for 2025
Within the scope of Medicare Advantage plans, Humana could stand as a prominent provider. Humana will likely offer a variety of Medicare Advantage plans in Rhode Island, each designed to cater to the unique needs of its members.
Some of these plans may act as a substitute for Original Medicare, potentially offering coverage that might surpass the confines of Medicare Part A and Part B.
Humana is one of the six private health insurance providers offering Medicare Advantage plans in Rhode Island. This could give residents multiple options to choose from for their healthcare coverage.
These plans could be designed to meet the needs of qualifying U.S. adults, particularly those who may be seeking convenient coverage under a single insurer or those with chronic health conditions.
Types of Humana Medicare Advantage Plans
Humana offers four different types of Medicare Advantage plans in Rhode Island: Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Special Needs Plans (SNPs), and Private Fee-for-Service (PFFS). Each of these plans has distinct features tailored to different healthcare needs.
The HMO plan operates on a network-based model, with enrollees choosing a primary care physician for health care coordination and referrals to specialists.
The PPO plan, which is a type of Medicare Advantage HMO PPO, encompasses all Medicare Part A and B benefits and allows you to consult out-of-network providers at an increased cost for doctor visits.
Lastly, the PFFS plan offers the flexibility to see any Medicare-approved doctor or specialist who agrees with the plan’s payment terms, eliminating the need to stick to a provider network.
Potential Features of Humana Plans
Some of Humana’s Medicare Advantage plans, including their Medicare Advantage HMO options, may be renowned for their comprehensive Medicare Advantage coverage. For starters, some of these Medicare Advantage plans may cover dental, vision, and hearing, which may not be included in Original Medicare.
Another distinguishing aspect of certain Humana’s plans could be their integration of prescription drug coverage. This means that enrollees could potentially have their prescription drugs covered under the plan.
Moreover, Humana might also offer a comprehensive network of healthcare providers, potentially making it easy for enrollees to access healthcare services. All these features could contribute to the potential cost-effectiveness of Humana’s Medicare Advantage plans.
Comparing Humana’s Top-Rated Plans in Rhode Island
The majority of Humana’s Medicare Advantage plans in Rhode Island have received high ratings, indicating their quality and reliability.
A testament to these ratings could be the fact that about 94% of Humana Medicare Advantage members in Rhode Island have been enrolled in plans rated 4 stars and above, with 61% in plans rated 4.5 stars and above.
Humana will likely be offering its highly rated Medicare Advantage plans in Bristol, Kent, and Newport counties. These plans may include access to lower-cost preferred pharmacies for prescription drug coverage.
Plan Ratings and Reviews
The Centers for Medicare & Medicaid Services (CMS) uses a 5-star rating system to evaluate Medicare Advantage plans.
This rating system will likely consider various factors, including access to services for non-English speaking beneficiaries. The ratings may be determined based on about 38 quality measures across five categories:
- Screenings
- Tests
- Vaccines
- Chronic conditions
- Member satisfaction
In previous years, some of Humana’s Medicare Advantage plans have received a 4.5-star rating from CMS. This could potentially underline the standard of Humana’s plans and their dedication to supplying superior healthcare services.
Potential Coverage and Benefits Comparison
Some of Humana’s highly rated Medicare Advantage plans in Rhode Island could potentially offer a diverse array of benefits, including:
- Dental coverage
- Vision coverage
- Hearing coverage
- Prescription coverage
However, it’s important to note that the coverage for certain prescription drugs may vary among Humana’s prescription drug plan options. For accurate information on the drug coverage of a particular plan, it’s recommended to sign in to MyHumana or directly contact Humana.
In addition to the possibility of having prescription drug coverage, Humana’s Medicare Advantage plans could also offer coverage for out-of-network care. However, the extent of this coverage will likely depend on the specific details of the plan.
Enrollment Process and Timeline for Humana Medicare Advantage Plans
Enrolling in a Humana Medicare Advantage plan involves a few simple steps. You can start your enrollment process three months before turning 65 and up to three months after your 65th birthday.
Medicare recipients can enroll in Medicare Advantage Plans during the annual fall open enrollment period, which runs from October 15 to December 7 each year.
The process may involve filling out an enrollment form with personal details that might include date of birth, address, and Medicare number. You’ll need to verify your eligibility for both Medicare and Medicaid before enrollment and select a plan that is available in your area.
Rhode Island residents also have the option to enroll online by selecting a plan and completing the enrollment form with their personal information.
The required documents for enrollment include your Medicare card, proof of residency, proof of age, and proof of citizenship or legal residency.
To enroll, call 1-833-641-4938 (TTY 711), Mon-Fri 8 am-9 pm EST, and get in contact with one of our licensed agents. They can provide comprehensive information, personalized guidance, and ongoing assistance to navigate the enrollment process for private insurance companies, making it easier for beneficiaries to make informed decisions about their healthcare.
Eligibility Requirements
To enroll in a Humana Medicare Advantage plan in Rhode Island, you must be at least 65 years old and enrolled in both Medicare Part A and Part B. Furthermore, you must be a citizen or permanent resident of the United States.
Also noteworthy, registering for a Humana Medicare Advantage plan in Rhode Island demands a qualifying health condition confirmed by a doctor. Therefore, it’s crucial to consult with your healthcare provider before starting your enrollment process.
Enrollment Periods
There are specific periods during which you can enroll in a Humana Medicare Advantage plan. The Initial Enrollment Period spans from 3 months before you turn 65, continues through your birthday month, and concludes 3 months after.
Another important period is the Annual Enrollment Period, which spans from October 15th to December 7th annually.
Additionally, there are Special Enrollment Periods (SEPs) during which you can enroll or change plans outside of the official periods. These SEPs may be triggered by specific life events and can differ in duration.
Tips for Choosing the Right Humana Medicare Advantage Plan
Selecting the appropriate Medicare Advantage plan might be complex, yet with the proper guidance, you can make a knowledgeable decision. The primary step in this process may be to assess your healthcare requirements and contrast different plans based on their potential coverage, benefits, and costs.
It’s also crucial to consider the possible expenses that could be linked to certain Humana Medicare Advantage Plans. These expenses may include:
- Premiums
- Deductibles
- Copayments
- Out-of-pocket costs
Therefore, a comprehensive assessment of these costs could aid you in estimating potential healthcare spending for the year.
Assessing Your Healthcare Needs
When assessing your healthcare needs, consider personal factors like origin, disability, gender, and other aspects such as:
- age
- lifestyle
- medical history
is crucial. You might also want to consider any specific health conditions or chronic illnesses you may have.
If you have a chronic illness, it’s important to choose a plan that may offer comprehensive support and services that could be tailored to managing your disease.
The use of prescription medication will likely also impact your plan selection, as Humana might offer Medicare prescription drug coverage that could assist in managing certain medication expenses.
Lastly, your family medical history may provide valuable insights into potential inherited health risks, which should be taken into consideration when choosing a plan.
Comparing Potential Costs and Benefits
To make an informed decision about which Humana Medicare Advantage plans to choose, it’s important to compare the potential costs and benefits of each plan. These may include:
- premiums
- deductibles
- copayments
- coverage details
- network options
- Possible benefits
It’s also important to consider the potential expenses that might be associated with certain Humana’s Medicare Advantage Plans. These expenses may include:
- Premiums
- Deductibles
- Copayments
- Out-of-pocket costs
Rhode Island-Specific Resources for Medicare Beneficiaries
Despite having all the information at your fingertips, maneuvering through the Medicare Advantage landscape could still be complex.
Thankfully, there may be a few Rhode Island-specific resources that could make the process easier.
The State Health Insurance Assistance Program (SHIP) in Rhode Island will likely provide a range of services, that may include:
- Information provision
- Assistance
- Education
- Counseling
These services could be designed to assist individuals in identifying suitable Medicare coverage options, possibly including dual eligible special needs plans, that might align with their needs and budget.
The program will likely aim to help Medicare beneficiaries and their families make well-informed decisions about their health insurance coverage, with the possible benefit of free language interpreter services and a licensed agent.
State Health Insurance Assistance Program (SHIP)
The State Health Insurance Assistance Program (SHIP) could be a valuable service to Medicare beneficiaries in Rhode Island. It could aid with plan selection and enrollment, possibly making the process easier for beneficiaries.
Rhode Island’s SHIP may also offer personalized assistance in identifying suitable Medicare coverage at a reasonable cost. It could aid beneficiaries in comprehending the intricacies of Medicare and assist them in navigating the array of available options.
Rhode Island residents may access SHIP services by contacting the Rhode Island State Health Insurance Assistance Program directly.
Our website
Another helpful tool for Rhode Island residents is this website. By putting your zip code into the zip code box that’s anywhere on this website, you can:
- Compare different Medicare Advantage and Prescription Drug Plans
- Focus on drug coverage and costs to find the perfect fit for your healthcare needs
- Input your information and sort through a variety of plans
- Weigh the pros and cons of each based on your situation
Summary
We’ve journeyed together through some of the potential Humana Medicare Advantage plans in Rhode Island, delving into the types of plans available, their possible features, ratings, and the enrollment process.
We also highlighted Rhode Island-specific resources that could help you make an informed decision about your healthcare coverage.
Remember, choosing the right Medicare Advantage plan is an important step toward ensuring your health and well-being. So, take the time to assess your healthcare needs, compare the potential costs and benefits of different plans, and utilize the available resources to decide which plan may best suit your needs and lifestyle.
Frequently Asked Questions
→ What is new in Humana in 2025?
In 2025, some of the Humana Medicare Advantage plans may include dental, vision, and hearing benefits, potentially providing more comprehensive coverage for members. For additional details about the plans for the 2025 calendar year, be sure to keep checking back to this website for updates.
→ What is the best Medicare Advantage plan?
Based on data from previous years, the best Medicare Advantage plan will likely be offered by Humana, as it could provide a good balance between quality coverage, affordable costs, various plan options, and the option to add additional benefits.
Many beneficiaries could find it appealing for these reasons.
→ What are the advantages of Humana Medicare Advantage?
Some of the advantages of Humana Medicare Advantage may include its broad range of choices for doctors and medical offices compared to Original Medicare, and its potential for reduced overall costs, especially for complex medical needs.
→ What types of Humana Medicare Advantage plans are available in Rhode Island?
In Rhode Island, Humana offers Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Private Fee-for-Service (PFFS) Medicare Advantage plans. Choose the one that best fits your needs.
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.