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Humana Medicare Advantage HMO Plans

Humana has many options for Medicare Advantage plans so that you can find the right one to fit your needs. If you are looking to save on your out-of-pocket healthcare expenses, you may want to consider an HMO plan. The benefits to our HMO plans in general are:

● Low monthly premium

● Low or no annual deductible

● An expansive list of network providers

With an HMO (Health Maintenance Organization) plan, you choose a primary care physician from our network of providers. You get unlimited visits to this provider with affordable copayments, and you are free to switch to a different physician at any time.


There are typically two main types of health insurance plans to choose from. What’s the difference?  With a PPO (Preferred Provider Organization), you can have more flexibility concerning the doctors or hospitals you use. However, these plans tend to be more expensive.

PPO plans allow you to see doctors and specialists outside of the Humana network without a referral from your primary physician. Though you may not get full coverage if you seek treatment outside of the network, you will still get some protection to keep expenses down.

Humana HMO Cost and Coverage

By law, Humana plans include the same coverage as Original Medicare plans. This coverage includes Medicare Parts A and B, which are hospital insurance and medical insurance. Humana HMO has some additional benefits, depending on your plan:

  • Dental, vision, and hearing care coverage
  • Free annual preventive health screenings
  • Gym membership
  • Health and wellness services
  •  Ability to have medications mailed to your home
  • Coverage for prescription drugs
  • Hospitalization coverage

Prescription drug coverage with Humana is equal to (if not better than) the standard for Medicare Part D. You also do not have to pay a separate premium for this coverage.

For some plans, you can pay as low as $0 per month. You can also expect lower out-of-pocket costs than many other Medicare Advantage plan types. Find available HMO plans in your area to compare prices.  

Humana also has a limit on your annual out-of-pocket expenses. After you reach this amount, you will not have to pay any more for covered care.

Humana Gold Plus HMO Plan

One of Humana’s HMO plans is the Humana Gold Plus plan for seniors. This plan provides you with services that original Medicare does not cover. For example, you can get prescription drug coverage, as well as reduced out-of-pocket costs.

With Humana Gold Plus, you only pay a $10 copay for primary care doctor visits. For specialist visits, you can expect your copay to be between $10 and $25. You also won’t pay more than $6,700 per year on covered health services with the out-of-pocket maximum for this plan.

Humana Gold Plus comes with the following hospital services:

  • $65 copay for emergency room visits
  • A reduced copay for ambulance services
  •  $0 to $25 copay for lab services covered by Medicare
  •  $250 copay for surgical center visits
  •  $10 to $25 copay for urgent care
  • Unlimited covered days for hospital stays
  • $10 copay for occupational therapy or speech therapy visits

Additional Coverage Included

Humana Gold Plus also includes dental services, hearing services, and vision services. Check your plan package to see your copay rates for these services in your area. Specific procedures must be covered by Medicare to fall under your Gold Plus plan.

You also get chiropractic coverage for Medicare-covered visits to the chiropractor and outpatient mental health coverage. This coverage is inclusive of:

  • Individual therapy visits with a psychologist or psychiatrist
  • Group therapy with a psychologist or psychiatrist
  • Partial hospitalization program services

For no extra cost than your regular prescription drug services, you can sign up for Humana’s mail order pharmacy. Save time by having your medications sent directly to your home.

Lastly, you can take advantage of these benefits to your Humana Gold Plus plan:

  • Well Dine Meal Program: after an inpatient stay, you can join Humana’s meal program to help you eat healthy stress-free.
  • Virtual medical visits: you can receive remote consultations from doctors and other practitioners via phone or video.
  • Virtual mental and behavioral health benefits: access mental health professionals to treat certain non-emergency issues from home.
  • Go365 program: get rewards for completing health and wellness activities.
  • Nurse hotline: get advice from registered nurses whenever you need it

How to Enroll in a Humana HMO

The process for enrolling in a Medicare Advantage HMO plan is straightforward. You can sign up for a plan during several enrollment periods:

1. Initial Enrollment Period

This period begins three months before you turn 65 and ends three months after. During this time, you can sign up for an Advantage plan. 

2. Annual Enrollment Period

From October 15th to December 7th, you can sign up for a plan, switch plans, or leave a plan.

3. Open Enrollment Period

During this period, which extends from January 1st to March 3rd, you can switch Advantage plans, leave a plan, or join a Medicare Part D plan. 

4. Special Enrollment Period

You may qualify for special enrollment, depending on your personal situation. Some qualifying events can include changing addresses, having a plan whose contract with Medicare changes, or losing your health insurance.

When you’ve chosen a plan, and are ready to enroll, give us a call for further instructions or apply online right here on our website. Have your Medicare card handy when you are ready to go through this process.

Compare Medicare Plan Options

Choosing a healthcare plan is an important decision. You need to consider various factors, including:

  • The total cost of your healthcare (adding the premium and out-of-pocket expenses)
  • The availability of different services in your area
  • Inclusion of additional services such as dental, vision, and pharmacy
  • Type of plan
  • Reach of provider network

If you aren’t sure which plan is right for you, contact us for a free plan comparison. Find out what our different options cover and get advice on what may be the best option for your needs and budget.

Humana Medicare Advantage Plans

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