Humana is consistently one of the top 5 largest carriers of health insurance in the U.S. and achieved this status by aggressively pursuing growth in its operations within government programs like Medicare and Medicaid. However, Humana more recently has focused its efforts on growing more commercial business.
By introducing new products, by expanding specialty policies to better include dental and vision options, and by adopting newer innovations and technologies, Humana looks to further increase its market share as a major player in the health insurance industry. The company is also actively pursuing strategic mergers, acquisitions, alliances, and investment opportunities to broaden its resources and reach.
One of Humana’s current initiatives is to work closely with primary care providers to encourage members to better maintain their health before getting sick and requiring healthcare services. Humana also established an official partnership with Walgreens in 2017 to operate ‘senior-focused primary care clinics’ inside its drugstores. This was in line with an increasing trend in the industry of tightening relationships between medical care providers and health insurance companies, and it has also proven to be the precursor to a new affiliation with Wal-Mart that will allow Humana to offer low-premium prescription drug plans (PDPs) to its Medicare members.
Services Currently Offered by Humana
Humana is heavily involved in providing services for Medicare & Medicaid programs, and it also administers managed care plans for other government programs, including Medicaid plans in Florida and Puerto Rico, and TRICARE (for military personnel) in its Southern Region.
Additionally, Humana offers:
Commercial Health Plans
Specialty Coverage (Life, Dental, and Vision)
Health Management Services
Outpatient Care Clinics
Clinical Programs including Home & Health
Wellness & Advance Population Initiatives
Starting in 2018, Humana discontinued its participation in ACA (Obamacare) health exchange policies.
Member Statistics for Humana Insurance
9.2m Active Retail Medical Membership
4.6m Active Group Medical Membership
7m Active Specialty Medical Membership
29.8k Active Business Medical Membership
14m Active Consolidated Medical Membership
7m Active Consolidated Specialty Membership
Humana’s membership has steadily increased since 2009 and is expected to continue this trajectory.
Health Provider and Facility Network
Humana keeps its provider network private to its members and strongly encourages accessing services with in-network providers. The company also directs primary care services to facilities that it owns & operates which includes 195 primary care clinics and 1,500 primary care clinicians, serving 27 markets across the country.
When establishing in-network facility relationships, Humana evaluates the facility for conditions treated, procedure outcomes, use of technology, nursing quality and staffing, type of hospital – teaching hospital, community hospital, etc.
And Humana physicians are assessed for their treating experience, special training, quality ratings, awards and recognition, publications, etc.
Coverage by State
Group and government policies are offered in every U.S. state, but the most comprehensive healthcare coverage policies offered by Humana are in: Arizona, Arkansas, California, Florida, Illinois, Kentucky, Louisiana, Missouri, Nevada, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, Texas.
Plans and Prices
Humana has individual and group plans with different focuses, including:
Simple and Affordable Preventative Options
Wellness and Engagement Programs
Flexible Level-Funded or Self-Funded Solutions
Copay and Coinsurance Variability
Identifying your primary focus will help you determine what policy will best meet the needs of you and/or your family.
Estimated Premium Rates:
35 Years of Age: $190 – $390 monthly National Average is $300/mo
45 Years of Age: $220 – $460 monthly National Average is $350/mo
55 Years of Age: $330 – $700 monthly National Average is $550/mo
Humana Benefits Levels
Humana’s benefits offering is largely variable and requires a qualification process that will guide you through each of the above mentioned focuses for all of the individual and family plans that are available in your state.
HUMANA HEALTH INSURANCE
Top Ten Reviews: 9.70 / 10
ADVANTAGES / Humana provides health insurance at a lower overall price point than most of its competitors, and its member services are evolving with a focus on primary care and better pharmacy access through strategic partnerships.
DISADVANTAGES / There is limited coverage availability in certain states for non-group and non-government Humana policies. A nationwide PPO is the only plan that allows flexible provider choice for members due to directive efforts towards tightly managed care operations.
CONSUMER TAKEAWAYS / Humana is an innovative carrier that investing in both primary care education and wellness programs for its members. In addition, Humana members can expect to pay low premiums relative to the market and are gaining increased access to pharmacy services. Humana scored an 9.70/10 overall review on Top Ten Reviews and is gaining momentum to be recognized as a quality consumer choice now that it is expanding beyond its traditional focus on government policies.