Will My Doctor Accept My Humana Medicare Plan?

At a glance:

  • $0 premium Medicare Advantage plans available in some areas1
  • Many plans offer prescription drug coverage and vision and dental benefits
  • Over 4 million people are enrolled in a Humana Medicare Advantage Plan2

Whether or not your doctor will accept your Humana Medicare plan depends on what Medicare plan you have and if your doctor is in your plan network.

Humana offers three different types of Medicare plans: Medicare Advantage plans, Medicare stand-alone prescription drug plans and Medicare Supplement Insurance plans.

Each type of plan has different network rules.

Humana Medicare Advantage Plans

If you are enrolled in a Humana Medicare Advantage plan, your network will depend on the type of plan you have, such as an HMO, a PPO or a PFFS, and the area in which you live. Each plan has different rules about which medical providers and facilities you can use and what the plan will cover.3

If you have a Humana HMO plan, you must choose an in-network primary care doctor. If you visit a doctor outside of your plan’s network, you may be responsible for paying all of the costs associated with that visit. You should ask your doctor if they are in your plan’s network before receiving any treatment or you may be responsible for paying some or all of your medical costs.

If you have a Humana PPO plan, you can visit any Medicare-approved doctor who accepts Humana’s plan terms and agrees to bill the plan. You should ask your doctor if they accept the plan terms before receiving any treatment or you may be responsible for paying some or all of your medical costs. You typically pay less out-of-pocket if you visit an in-network provider.

If you have the Humana PFFS plan, you can visit almost any Medicare-approved doctor who accepts Humana’s plan terms and agrees to bill the plan. You should ask your doctor if they accept the plan terms before receiving any treatment or you may be responsible for paying some or all of your medical costs.

Humana Medicare Prescription Drug Plans

Medicare stand-alone prescription drug plans only provide prescription drug coverage. Your costs may depend on the pharmacy you use.

Depending on the Humana prescription drug plan you choose, your copayments and coinsurance may be less expensive if you fill them at certain network pharmacies.4 If you are unsure if your pharmacy is a preferred cost-sharing pharmacy, you should call and ask Humana before you fill your prescriptions.

Humana Medicare Supplement Insurance Plans

Medicare Supplement Insurance plans (also called Medigap) work with Original Medicare and can help cover some of the out-of-pocket costs not covered by Medicare Part A and Part B, such as Medicare copayments, coinsurance and deductibles.5

Medicare Supplement Insurance plan availability can vary by state.

Which Humana Medicare Plan Is Right for Me?

If you need help finding a Humana Medicare plan that accepts your current doctor, you can call a licensed insurance agent6 directly at  TTY Users: 711 24 hours a day, 7 days a week. You can also request a free plan quote online to compare your options, with no obligation to enroll in a plan.

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