Humana Medicare Advantage Plans with Dental Coverage
Looking for Humana Medicare Advantage plans with dental coverage? In this article, we outline which dental benefits are included in these comprehensive Humana Medicare Advantage plans with dental for 2025, such as routine cleanings and X-rays, so you can confidently choose a plan that keeps your smile bright and your out-of-pocket costs low.
Key Takeaways
- Starting in 2024, Humana Medicare Advantage plans will include comprehensive dental coverage which includes preventive care, exams, cleanings, X-rays, fillings, extractions, oral surgery, and in some cases, orthodontic treatments.
- Humana also provides vision and hearing benefits, language interpreter services, and support for members with special needs through plans that integrate benefits of Original Medicare with additional services tailored for individuals with chronic conditions or dual eligibility.
- Humana’s non-discrimination policy ensures equal access to its services, accommodating members with disabilities and complying with all applicable laws and regulations to provide Special Needs Plans and additional benefits for members requiring extra assistance.
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Understanding Medicare Advantage Plans
Serving as a Medicare Advantage organization, Humana operates under a contract with Medicare and a Coordinated Care plan contract with the state Medicaid program. Medicare Advantage plans provide coverage for the same services as Original Medicare Part A and Part B, with the addition of prescription drug coverage and extra benefits.
These plans potentially extend coverage to include additional benefits such as:
- Prescription drug coverage
- Vision services
- Hearing services
- Dental services
- Wellness services
These additional benefits may vary by state, such as CA, CT, DC, DE, NY, OH, or PA, and MD, ME, MI, MN, and continue to pay value to the users, including those with military or veteran status.
The variety among Medicare Advantage plans, including Medicare Advantage HMO PPO options, is reflected in their unique networks of doctors and hospitals. For instance:
- HMO members typically require a primary care physician and referrals for specialists
- PPOs provide greater flexibility in accessing out-of-network providers in states like New York, Ohio, Oregon, and Pennsylvania
- PFFS plans lack a network, allowing members to visit any provider who accepts Medicare and the plan’s terms, often offering additional benefits like prescription drug, dental, and vision coverage.
Plan availability is restricted to certain areas, with costs like monthly premiums, deductibles and copays potentially varying based on location and the specific plan chosen.
Dental Benefits in Humana Medicare Advantage Plans
In 2024, Humana will include dental coverage in all their Medicare Advantage plans, ensuring ongoing comprehensive dental care for members. The dental services covered under Humana Medicare Advantage plans in 2025 include:
- Annual exams
- Two complimentary cleanings per year
- Dental X-rays every 5 years
- Routine teeth cleanings and exams
- Additional dental X-rays
- Fillings
- Tooth extractions
- Preventive care
- Restorative care
- Oral surgery
These services cater to the diverse dental needs of people enrolled in these plans.
Additionally, a range of dental procedures including fillings, extractions, and root canals are covered under Humana Medicare Advantage plans.
Comprehensive Dental Coverage
Humana’s Medicare Advantage plans cover preventive dental care, such as routine exams, cleanings, and X-rays, with in-network coverage generally at 100% after meeting the lifetime deductible, and out-of-network coverage around 80%.
Fundamental dental services covered under Humana’s Medicare Advantage plans consist of an annual exam, two complimentary cleanings per year, and dental X-rays once every 5 years. These services play a crucial role in preserving oral health and averting potential complications.
Indeed, a majority of over 87% of Humana Medicare Advantage members have integrated benefits that encompass certain major services, including specific restorative procedures like fillings and crowns.
Furthermore, Humana’s Medicare Advantage plans do provide orthodontic coverage, offering supplementary options for individuals in need of such treatments.
Access to a Wide Network of Dentists
Humana Medicare Advantage Plans offer an extensive network of dental providers. Members can conveniently find a nearby dentist by specifying their coverage type and submitting their ZIP code on Humana’s website.
Humana’s Medicare Advantage Network encompasses a variety of dental specialties, including general dentistry, preventive care, and diagnostic services, which beneficiaries can access.
Members should be aware that to benefit from dental coverage under Medicare Advantage Plans, they must exclusively use dentists within the Humana network, since out-of-network services are not covered.
Lower Cost Preferred Pharmacies
Utilizing Humana’s preferred pharmacy network can offer prescriptions at a reduced cost compared to standard in-network pharmacies and may encompass $0 copays and simplified access to prescriptions.
CenterWell Pharmacy is the designated cost-sharing mail-order pharmacy for numerous Humana MAPD and PDP plans. Additionally, there are other pharmacies that are part of Humana’s preferred pharmacy network.
To find a preferred pharmacy within Humana’s network, visit the Humana website and enter your location in the ‘Refine your search’ area to obtain the search results.
Additional Benefits and Services
Humana Medicare Advantage Plans offer vision coverage that includes:
- Annual eye exams
- An annual allowance for eyeglasses or contact lenses
- Glaucoma screenings
- Diabetic eye exams
Additionally, some plans may provide an extra vision allowance. The Humana Medicare Advantage Plans also provide complimentary language interpreter services to members who require assistance due to non-English speaking or additional support needs.
Humana provides support to its Medicare Advantage members with special needs through the offering of Special Needs Plans (SNPs) that include benefits of Original Medicare, additional support, and services, and starting in 2024, all Humana Special Needs Plans will also include dental, vision, and hearing benefits.
Furthermore, all D-SNPs come with a Healthy Options Allowance for various expenses such as:
- food
- pet supplies
- utility bills
- rent
Vision and Hearing Coverage
All Humana Medicare Advantage plans include the following benefits:
- Routine dental care
- Routine vision care, including annual exams, eyeglass frames with prescription lenses, and prescription contact lenses
- Coverage for hearing aids and their fittings
The inclusion of vision and hearing coverage in all 2024 Humana Medicare Advantage plans demonstrates their comprehensive nature in the market.
Free Language Interpreter Services
Complimentary language interpreter services are available to Humana members through Humana Customer Service.
They have the option to engage with an interpreter by contacting the number provided on the back of their member ID card (TTY: 711) or by dialing 877-320-1235, selecting option 9 (TTY: 711) between the hours of 8 a.m. and 8 p.m. Eastern time.
Humana’s complimentary language interpreter services encompass a variety of languages, guaranteeing that members have access to language support in their preferred language.
Humana adheres to a structured plan that delineates procedures and criteria for delivering language assistance to individuals with limited English proficiency, thus strengthening their dedication to high-quality language services.
Furthermore, complimentary language interpreter services are provided in all Humana Medicare Advantage Plans, guaranteeing that all members have access to healthcare communication that is both effective and meaningful.
Support for Members with Special Needs
Humana Medicare Advantage offers Special Needs Plans (SNPs) which integrate the advantages of Original Medicare with extra assistance for members with special needs.
These plans are customized to the distinct healthcare needs of individuals with chronic conditions or dual eligibility, providing coverage for:
- regular dental care
- vision care
- hearing care
- prescription drugs
Humana also incorporates Care Management programs for high-risk members as a component of Medicare Advantage plans.
Humana Medicare Advantage SNPs cater to individuals with chronic conditions, those with dual eligibility for Medicare and Medicaid, and others with special needs by offering plans with additional benefits and services tailored specifically for them.
These encompass prescription drug coverage and, in most instances, routine dental, vision, and hearing care. Starting in 2024, all Humana Special Needs Plans will include these benefits.
Humana Medicare Advantage has specialized customer service teams that specifically address the needs of members enrolled in Special Needs Plans, ensuring that individuals with special needs receive the necessary support and assistance.
Service accessibility for members with disabilities is guaranteed by Humana Medicare Advantage through a variety of methods, including:
- Over-the-phone interpretation in more than 150 languages
- TTY services
- Alternative formats such as braille, large print, audio, DAISY, and screen-reader accessible PDFs
Additionally, they provide resources specifically designed to improve the web experience for members with diverse accessibility needs.
Navigating Plan Options and Costs
When selecting a Humana Medicare Advantage plan, consider:
- Evaluating the coverage for vision, dental, and hearing services not included in Original Medicare
- Understanding the different Medicare Advantage plans and comparing their benefits, costs, and coverage
- Considering the plan options available in your specific location.
In order to be eligible for Humana Medicare Advantage plans, individuals must be either 65 years of age or older, younger than 65 with a qualifying disability, or have ESRD (end-stage renal disease).
Coverage and Benefits Vary by Location
The coverage and benefits of Humana Medicare Advantage plans do indeed vary depending on the location. This variation can encompass differences in costs, coverage, and specific benefits offered.
For instance, while certain plans may have a $0 monthly premium, the out-of-pocket maximum and copays for services like primary care and specialist visits may vary across different geographic areas.
The specific benefits in Humana Medicare Advantage Plans, such as allowances for routine dental, vision, and hearing, can vary depending on the member’s location. Although some benefits are uniform across all plans, others may be accessible only in specific areas.
Enrollment Periods and Eligibility
Eligibility for enrolling in Humana Medicare Advantage plans includes being at least 65 years old, or if younger than 65, having a qualifying disability or ESRD, a permanent kidney failure that requires dialysis or a kidney transplant.
The designated enrollment periods for Humana Medicare Advantage plans are the Annual Election Period from October 15 through December 7, and the Medicare Advantage Open Enrollment Period from January 1 through March 31.
Indeed, it is permissible to enroll in a Humana Medicare Advantage plan outside of the standard enrollment periods during a Special Enrollment Period (SEP). You can enroll in any Humana plan, if the contract is renewed. This renewal is a requirement for enrollment.
Assistance with Plan Selection
Indeed, Humana does provide personalized guidance for selecting a Medicare Advantage plan. They can assist you in finding the plan that most closely aligns with your healthcare needs and offer tailored education and support.
Humana offers various tools to help individuals comprehend and compare different plan options to select the most suitable one based on their requirements. These tools include features like routine dental, vision, and hearing benefits that are included in all their Medicare Advantage plans.
The Humana website offers the ability to compare different Medicare Advantage plans through the utilization of their Medicare resources page and comparison tools. By accessing these resources, users can conduct a side-by-side comparison of various types of Medicare Advantage plans, such as:
- HMO
- PPO
- PFFS
- Special Needs plans
This allows users to effectively assess benefits, costs, and coverage.
When selecting a Humana Medicare Advantage plan, it is crucial to take into account factors such as the coverage for vision, dental, and hearing services that are not covered by Original Medicare and understanding the different types of Medicare Advantage plans to compare their benefits, costs, and coverage effectively.
Ensuring Equal Access and Non-Discrimination
Adhering to Federal civil rights laws, Humana Inc. and its subsidiaries work to prevent discrimination based on factors such as race, age, and gender identity or expression transgender. They are committed to providing equal opportunities to all individuals.
Humana provides Dual-Eligible Special Needs Plans (D-SNPs) for individuals who are eligible for both Medicare and Medicaid, ensuring coverage for both Medicare and Medicaid benefits.
Humana ensures equitable access for all Medicare Advantage Plan members by providing healthcare benefits to all plan members in accordance with CMS requirements.
Non-Discrimination Policy
Humana’s non-discrimination policy asserts that individuals are not discriminated against or excluded based on national origin, age, disability, sex, marital status, veteran status or religion, or language.
It is important to note that discrimination is illegal.
Accommodations for Members with Disabilities
To enhance the web experience for members with disabilities, Humana offers accessibility resources, enabling efficient access and usage of online information. Additionally, they provide communication assistance, including free language interpreter services for members in need of additional support.
Humana provides Dual-Eligible Special Needs Plans (D-SNPs) for individuals with both Medicare and Medicaid, offering special benefits and prescription drug coverage. For those with specific chronic conditions, there are Medicare Advantage Chronic Condition Special Needs Plans (C-SNPs).
Additionally, Humana offers on-site dedicated care management services and comprehensive care to assist members with disabilities in understanding and utilizing their Medicare Advantage plan.
Members with disabilities can request accommodation with Humana Medicare Advantage Plans by contacting their dedicated helpline at 1-888-204-4062 (TTY: 711), which is available daily from 8 a.m. to 8 p.m.
There are tools and resources specifically tailored for Humana Medicare Advantage Plan members with disabilities, encompassing coverage options customized to their requirements, along with predictive modeling tools and assessment processes to ascertain eligible patients based on their disabilities.
Compliance with Applicable Laws and Regulations
Operational and reimbursement guidelines, provider qualifications, and requirements apply to Humana Medicare Advantage Plans. Additionally, there are common healthcare terms and provisions that apply to these plans. Humana guarantees adherence to Medicare Advantage Plan regulations through the implementation of:
- Rigorous operational and reimbursement guidelines
- Stringent provider qualifications and requirements
- Provision of annual compliance training for contracted entities.
Humana has established a formal grievance process to allow members to register complaints if they are unsatisfied with their Medicare healthcare plan, Customer Care, or provider. This process outlines the necessary steps for filing a grievance.
Summary
Humana’s Medicare Advantage plans offer a holistic approach to healthcare, providing not only medical coverage but also comprehensive dental, vision, and hearing benefits. They provide equal access and non-discrimination for all members, ensuring everyone receives the care they need.
Whether you’re considering enrollment or already a member, this guide should provide you with a clearer understanding of the opportunities and benefits these plans offer.
Frequently Asked Questions
→ What is the biggest disadvantage of Medicare Advantage?
The biggest disadvantage of Medicare Advantage is the limited choice of doctors and medical offices, and it can cost more overall if you have complex medical needs.
It is best suited for those who don’t require expensive treatments or tests.
→ What is the difference between Medicare and Humana Medicare Advantage?
The main difference between Medicare and Humana Medicare Advantage is that Medicare Advantage is offered by private health insurance companies and includes additional benefits like prescription drug coverage.
Traditional Medicare, on the other hand, is managed by the federal government and does not typically include these additional benefits.
→ Why are people leaving Medicare Advantage plans?
Many people are leaving Medicare Advantage plans due to excessive prior authorization denial rates and slow payments from insurers.
These challenges have led to dissatisfaction and prompted individuals to seek alternative coverage.
→ What dental benefits are included in Humana’s Medicare Advantage plans?
Humana’s Medicare Advantage plans include a range of dental benefits such as annual exams, cleanings, X-rays, and various treatments like fillings and extractions. These plans offer comprehensive coverage for oral health needs.
→ What extra benefits and services are offered by Humana Medicare Advantage plans?
Humana Medicare Advantage plans offer extra benefits such as vision and hearing coverage, free language interpreter services, and support for members with special needs.
These additional services can provide valuable support and coverage for various health 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.