Humana Medicare Advantage Plans Texas 2025
Welcoming the new year is always exciting, especially when it comes with enhanced healthcare benefits.
If you reside in Texas and are shopping for different Medicare plans, Humana Medicare Advantage Plans Texas 2025 offerings might be exactly what you’re looking for.
With a variety of HMO, PPO, and PFFS options, these plans are designed to cater to a wide range of beneficiary needs and preferences.
Key Takeaways
- Humana offers a broad range of Medicare Advantage plans in Texas for 2025, with increased availability of local PPOs, averaging 49 plans for beneficiaries including HMO, PPO, and PFFS options to cater to various healthcare needs.
- The Humana Medicare Advantage plans promote affordability through competitive premiums, with over half of the beneficiaries having an opportunity to enroll in a $0 premium plan, but costs can vary based on several factors like income level and selected coverage options.
- Humana’s Medicare Advantage plans provide additional benefits, including dental, vision, and hearing coverage, as well as prescription drug coverage, ensuring comprehensive healthcare beyond basic Medicare provisions.
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Overview of Humana Medicare Advantage Plans in Texas for 2025
Humana Insurance Company is a well-established name in the healthcare sector, known for offering an array of Medicare Advantage plans that are thoughtfully designed, keeping in mind the diverse needs and preferences of Medicare-eligible individuals. I
n 2025, Texas beneficiaries, even those in rural areas, will have an average of 49 Humana Medicare Advantage plans available.
Over the years, Humana has notably increased the availability of local PPOs in its Medicare Advantage plans in Texas. From 24% in 2017, this figure has risen to 42% in 2025. Humana provides a variety of plans including HMO, PPO, and PFFS to cater to your specific needs.
Humana HMO Plans
Humana’s Health Maintenance Organization (HMO) plans are a popular choice among beneficiaries due to their cost-effectiveness. With an anticipated average monthly premium of only $18.50, these plans are a budget-friendly option that doesn’t skimp on benefits.
A key characteristic of HMO plans is the requirement of referrals for specialist visits. Under Humana’s HMO plans, a referral from your primary care physician is required to see a specialist.
This structure ensures that you receive coordinated and comprehensive healthcare services within Humana’s extensive HMO network.
Humana PPO Plans
For those who value flexibility in choosing healthcare providers, Humana’s Preferred Provider Organization (PPO) plans are a great fit. These plans offer a broader selection of healthcare providers compared to Medicare Advantage HMO PPO plans, thus providing beneficiaries with a wider range of options to meet their medical needs.
PPO plans offer:
- Provider choice flexibility
- Out-of-network services (may incur additional costs)
- Balance of flexibility and cost-effectiveness (with careful consideration and planning)
Humana PFFS Plans
Humana’s Private Fee-for-Service (PFFS) plans offer a significant level of flexibility, including:
- Beneficiaries can receive care from any healthcare provider that accepts the plan’s terms and conditions
- No restriction to a specific network of providers
- Freedom to choose providers that best suit your healthcare needs
These plans are particularly beneficial for individuals who require specialized care or have providers who are not part of Humana’s network.
However, you should ensure that your selected providers, as well as other providers, accept the terms and conditions of Humana’s PFFS plans and agree to bill Humana directly.
Premiums and Cost Sharing for Humana Medicare Advantage Plans
Financial considerations play a pivotal role in choosing a Medicare Advantage plan. With Humana’s offering Medicare Advantage plans, you can look forward to:
- Affordable premiums
- Fair cost-sharing structures
- In fact, for 2025, over 54% of Humana’s anticipated Medicare beneficiaries in Texas will have the opportunity to enroll in a $0 monthly premium plan.
While the costs associated with these plans are generally affordable, they can vary depending on several factors. These factors include:
- The monthly Medicare Part B premium
- The beneficiary’s income level
- Additional benefits provided by the plan
- The presence of a low-income subsidy (LIS) for the enrollee
- Reinsurance costs
- Risk-sharing mechanisms
Thus, it would be wise to review all potential costs thoroughly before making a final decision.
Average Monthly Premiums
When it comes to average monthly premiums, Humana’s Medicare Advantage plans in Texas are quite competitive.
For 2025, the estimated average monthly premium is just $18.50. However, these premiums are subject to change and may vary based on factors such as:
- the specific plan details
- coverage options
- the beneficiary’s location
- their age and health status.
Interestingly, Humana’s average monthly premium in Texas stands at $9.36, a figure considerably below the national average of $18.50.
This could be attributed to Humana’s commitment to offering affordable healthcare to all Medicare beneficiaries, regardless of their financial circumstances.
Cost Sharing and Out-of-Pocket Expenses
Cost-sharing is a significant aspect of Medicare Advantage plans, and understanding how it works can help you make an informed decision. In Humana’s Medicare Advantage plans, cost-sharing refers to the portion of healthcare expenses for which the individual is responsible.
It’s worth noting that out-of-pocket expenses can differ significantly among different Humana Medicare Advantage plans. These variations are mainly due to differences in premiums, deductibles, and copays among the different plans.
Thus, when choosing a plan that fits your financial and medical needs, comparing these details is essential.
Extra Benefits Offered by Humana Medicare Advantage Plans
One of the standout features of Humana’s Medicare Advantage plans, including their Medicare Advantage HMO options, is the additional benefits they offer to Medicare advantage members, such as:
- Dental coverage
- Vision coverage
- Hearing coverage
- Telehealth services
These plans go above and beyond to ensure comprehensive healthcare for beneficiaries.
These additional services not only make Humana’s plans more appealing but also promote overall health and well-being.
After all, healthcare is more than just managing illness; it’s about promoting overall wellness and quality of life through Humana insurance services.
Dental Coverage
Good oral health is an essential aspect of overall health, and Humana’s Medicare Advantage plans recognize this. Their dental coverage includes preventive services like yearly exams, two complimentary cleanings annually, and dental X-rays once every 5 years.
Certain Humana plans offer coverage for comprehensive dental services, which could include:
- Routine check-ups and cleanings
- Fillings
- Root canals
- Orthodontic procedures
With this in-depth dental coverage, maintaining your oral health need not be a concern for costly expenses.
Vision and Hearing Coverage
Eye and ear health are often overlooked aspects of healthcare, but not with Humana’s Medicare Advantage plans. These plans offer coverage for routine vision and hearing care, ensuring that you can see and hear the world around you.
The vision benefits include coverage for eyeglass frames and lenses, with certain frequency limitations. On the other hand, the hearing benefits include partial coverage for hearing aids, with an annual allowance and restrictions on certain brands.
Such extensive vision and hearing coverage can improve your life quality and facilitate a more immersive engagement with your surroundings.
Telehealth Services
In today’s digital age, healthcare has evolved to meet the needs of patients wherever they are, thanks to telehealth services. Humana’s Medicare Advantage plans offer telehealth services, which provide virtual access to medical doctors round the clock and scheduled appointments with behavioral health specialists.
These services have revolutionized the way we access healthcare, making it more convenient and accessible. Telehealth services allow for easy access to quality healthcare, whether for a quick consultation or regular follow-ups.
Prescription Drug Coverage in Humana Medicare Advantage Plans
Prescription drug coverage is a significant component of Humana’s Medicare Advantage plans. Most of these plans, including all Special Needs Plans, offer coverage for prescription medications.
This means that whether you need medication for a short-term illness or require regular medication for a chronic condition, Humana has got you covered.
Different drug tiers and preferred pharmacies are strategies Humana employs to incorporate this coverage. Each medication is allocated to a specific tier, which in turn sets the copayment or coinsurance amount for that drug.
Preferred pharmacies are part of a network that offers reduced drug prices, providing beneficiaries with lower cost-sharing and extra savings on prescription medications.
Prescription Drug Tiers
Understanding prescription drug tiers can help you anticipate your medication costs. In Humana’s Medicare Advantage plans, these tiers categorize the covered drugs in their formulary, which is a list of the most prescribed medications.
Humana’s plans classify prescription drugs into five tiers:
- Tier 1 includes preferred, low-cost generic drugs
- Tier 2 comprises non-preferred and low-cost generic drugs
- Tier 3 consists of preferred brand-name drugs
- Tier 4 includes non-preferred brand-name drugs
- Tier 5 covers specialty drugs
Each tier corresponds to a specific copayment or coinsurance amount, which can influence your out-of-pocket costs.
Lower Cost Preferred Pharmacies
Humana’s Medicare Advantage plans also enable savings on prescription medications through lower-cost preferred pharmacies.
These pharmacies, including CenterWell Health Care Services’ Pharmacy and specific Walmart locations, offer reduced drug prices, leading to lower cost-sharing and extra savings on prescription medications.
To take advantage of these savings, simply locate a nearby preferred cost-share pharmacy using Humana’s pharmacy locator tool and present your plan card when filling your prescriptions. This way, you can enjoy the benefits of your plan while keeping your medication costs manageable.
Enrollment Process and Contract Renewal
Deciding on a Medicare Advantage Plan is just the first step. Once you’ve chosen a Humana plan that suits your needs, the next step is to enroll.
Luckily, Humana makes the enrollment process straightforward and offers several ways to enroll, including online, over the phone, or through a licensed Humana sales agent.
After enrollment, be aware that your Medicare contract is up for renewal annually. If you continue to pay your Medicare premiums, your coverage should be renewed each year without any need for additional action.
How to Enroll
Enrolling in a Humana Medicare Advantage plan is a simple process. You can complete the online application on the Social Security Administration’s website, call Humana’s enrollment hotline, or consult with a licensed insurance agent.
Ensure you have all the required documentation at hand before enrolling. This may include your Medicare card, proof of residency, and identification paperwork.
Also, remember to enroll during the Medicare Open Enrollment Period, which runs from October 15th to December 7th for the year 2025.
Contract Renewal
Following enrollment in a Humana Medicare Advantage plan, you can anticipate your plan to be automatically renewed each year. If you continue to pay your Medicare premiums, your coverage should be renewed each year without any need for additional action.
However, it’s a good idea to review your plan during the Medicare Open Enrollment Period, which runs from October 15th to December 7th. If your health needs or financial situation change, you can modify your plan during this period.
Special Needs Plans and Dual Eligible Beneficiaries
If you have specific health needs, you may benefit from Humana’s Special Needs Plans (SNPs). SNPs offer specialized healthcare and extra benefits for those with certain chronic conditions, those institutionalized, or those eligible for both Medicare and Medicaid.
For those who are eligible for both Medicare and Medicaid, Humana offers Dual-Eligible Special Needs Plans (D-SNPs) in various states, including MD, ME, MI, MN.
These plans offer special benefits, including prescription drug coverage, and are tailored to address distinct healthcare requirements.
Special Needs Plans (SNPs)
Humana’s Special Needs Plans (SNPs) are specifically crafted for those with certain chronic conditions or those in institutionalized settings.
These plans provide personalized care and coverage to address specific requirements, and the effectiveness of a Humana plan depends on the individual’s unique needs.
For example, if you have a chronic condition such as diabetes or cardiovascular disorder, you may qualify for a Chronic Condition Special Needs Plan (C-SNP). If you’re in an institutionalized setting, you could be eligible for an Institutional Special Needs Plan (I-SNP).
Dual Eligible Beneficiaries
If you qualify for both Medicare and Medicaid, you’re considered a dual eligible beneficiary. Humana’s Dual-Eligible Special Needs Plans (D-SNPs) provide a variety of supplementary benefits, including:
- Prescription drug coverage
- Dental coverage
- Vision coverage
- Hearing coverage
These plans are specifically tailored to maximize the benefits available to dual-eligible beneficiaries, including those who have served Medicare beneficiaries.
Summary
Humana’s Medicare Advantage Plans in Texas for 2025 offer an impressive range of options to suit varying needs and preferences. Whether you’re looking for an HMO, PPO, or PFFS plan, Humana has got you covered.
With affordable premiums, comprehensive coverage, and additional benefits like dental, vision, hearing, and telehealth services, these plans offer excellent value for beneficiaries.
For those with specific health needs, Humana’s Special Needs Plans (SNPs) and Dual-Eligible Special Needs Plans (D-SNPs) provide tailored coverage and special benefits. The enrollment process is straightforward, and with automatic contract renewal, maintaining your coverage is a breeze.
Choosing a Medicare Advantage plan is an important decision that can significantly impact your healthcare experience. With Humana’s wide range of plans and comprehensive benefits, you can find a plan that perfectly suits your healthcare needs and financial situation.
Frequently Asked Questions
→ What is new in Humana in 2025?
In 2025, Humana is offering $0 monthly plan premium, Part B giveback, dental, vision, and hearing coverage, as well as coverage that works alongside VA health care, in all USAA Honor plans.
Additionally, all Humana Medicare Advantage plans now include dental, vision, and hearing benefits.
→ What is the best Medicare Advantage plan for 2025?
One of the best Medicare Advantage plans for 2025 is offered by Humana, known for high-quality ratings, good customer satisfaction, widespread availability, and numerous $0-per-month plans.
Customers report better quality of healthcare compared to other plans, making it a top choice.
→ What is the Humana over-the-counter allowance for 2025?
In 2025, Humana will provide a $100 quarterly allowance for over-the-counter health and wellness products through their OTC mail-order provider. The unused amount expires at the end of the quarter.
→ What are the disadvantages of Humana Medicare Advantage?
The biggest disadvantage of Humana Medicare Advantage is the limited choice of doctors and medical offices compared to Original Medicare.
Additionally, the plans can cost more for those with complex medical needs.
→ What types of Medicare Advantage plans does Humana offer in Texas for 2025?
In 2025, Humana offers HMO, PPO, and PFFS Medicare Advantage plans in Texas.
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.