Humana Health Insurance

As an authorized agent for Humana Health Insurance, HSA for America is proud to offer the lowest rates available on Humana Health Insurance plans.  Our site has complete information, instant quotes, and we are available to answer any questions you have.  Humana Health Insurance offers two very competitive products, the Humana One plan, and the Humana HSA.

The Humana One plan (below) is very popular for those looking for a lower-priced full service plan, even offering coverage for prescriptions and a limited number of doctor office visits.

The Humana HSA plan works in conjunction with a Health Savings Account, and offers one of the best values available for HSA plans.  It is a low-priced HSA-compatible plan that includes coverage for doctor visits and prescription drugs, which is something many of the lower-priced HSA plans don’t do.  Visit our Humana HSA plan page for complete details.

Humana Health Insurance has been assigned an A.M. Best rating of "A-" (Excellent).

Plan: Humana One

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Humana Health Insurance has especially attractive rates on their high deductible plans, and on plans for large families, while still offering coverage for prescription drugs and doctor's office visits that most other high deductible plans do not cover.

Before you apply, be sure to view your Humana Health Insurance state brochure.  It contains important information regarding benefits, exclusions, limitations, renewability, and other terms of coverage.

Plan at a Glance:                         

To be covered, services must be medically necessary and specified as covered.  Please see your policy for more information on medical necessity and other specific plan benefits.

1. Benefits payable after 12-month waiting period.
2. Up to a combined maximum of $300 per person per calendar year.
3. Outpatient benefits payable after 90-day waiting period for nonemergency removal of tonsils and/or adenoids, and 180-day waiting period for nonemergency surgical treatment for bunions, varicose veins, hemorrhoids or hernia (does not include strangulated or incarcerated hernia).
4. This benefit covers well-baby charges for a hospital stay of 48 hours following a vaginal delivery and 96 hours following a Cesarean section.  If delivery occurs after 8:00 p.m., coverage will continue until 8:00 a.m. the following morning.
5. Prior authorizations required in order to be eligible for these benefits.
6. The benefit maximum for covered dependent children to age 5 who have a congenital defect or birth abnormality will be 20 visits per year each for physical, occupational and speech therapy.
7. This benefit covers a newborn dependent born with cleft lip and/or palate not subject to any age limit.
8. Bereavement limited to $1,150 per family for the 12 month period following death.  Nursing, social/counseling services, and certified nurses aid or delegated nursing services limited to $9,100 per member per benefit period.
9. When you obtain care from nonparticipating providers:
   - 50% of your payment toward the deductible is credited to the deductible for participating providers.
   - 50% of your out-of-pocket costs are credited to the out-of-pocket maximum for participating providers.
   Once you meet your deductible and out-of-pocket expense limits, the plan pays 100% for covered services.  Participating provider covered expenses are not credited to the nonparticipating provider deductible or out-of-pocket maximum.
10. Copayments do not apply toward deductibles or out-of-pocket maximums.  The out-of-pocket maximum does not apply to transplant services from nonparticipating providers, prescription drugs, or mental health services.
11. Two or three family members must meet their individual deductibles, depending on the deductible amount selected.
12. These benefits are optional and can be added to your plan for an additional cost.
13. This benefit does not cover MRI, CAT, EEG, EKG, ECG, cardiac catheterizations or pulmonary function studies.
14. Primary care physicians include family practitioner, general practitioner, pediatrician or internist and specialist contains any other participating physician.
15. Nonparticipating providers may balance bill you for the difference between the amount paid by us and the non-participating providers billed charges if:
    

a.	Your are required to travel no more than reasonable distance beyond the plan's service area in order to receive services from a participating provider;

b.	The covered person knowingly seeks services from a nonparticipating provider; and

c.	The nonparticipating provider is reimbursed for an amount less than the billed charge.

Children services are not subject to deductible for age appropriate visits and routine immunizations, and are subject to the coinsurance limits of your plan.  Age specific mammogram screening and prostate screening are covered and are not subject to deductible or coinsurance.  Maximum payment of $500 per year.

This information is presented only as a very brief overview of some of the benefits of this plan, and is intended only for general education.  The amount of benefits provided depends on the plan selected. Premium will vary with the type of benefits selected.  These plans contain exclusions from and limitations of coverage.  Please see the product brochure for more complete information, as well as information about terms of renew ability, preexisting conditions, out-of-network penalties, and notification requirements.  Plans are subject to health underwriting.  To be considered for reimbursement, expenses must qualify as covered expenses.  Expenses are also subject to reasonable and customary limits, unless you use a network, and all other policy provisions, including determinations of medical necessity.

Coverage Synopsis:

Choose a deductible of $500, $1,000, $2,500, or $5,000.  The Humana Health Insurance policy then pays 80% of the next $10,000 in covered expenses, then 100% up to $5,000,000.  Doctor visits are covered at 80%, after the deductible. Prescription drugs are covered after a $500 deductible, with co-payments of $10 co-pay for generic, $30 for brand name drugs, or $50 for drugs not listed on their formulary list.

We also like the fact that Humana Health Insurance allows you to communicate directly with the claims department if you have any questions about a medical claim.

Rates:

Humana Health Insurance rates vary based on age, zip code of residence, optional riders, and other factors.  Their rates are very competitive on their higher deductible plans, and for plans to cover large families.  When running your quote, please note that rates are often lower when placing the younger spouse as primary insured.

The premium can be paid via monthly, quarterly, semi-annual, or annual billing, or a monthly bank draft.  The bank draft will occur on the premium due date each month.  The initial premium can be paid with a check or credit card.

PPO Network:

The Humana Health Insurance ChoiceCare network includes more than 320,000 physicians and ancillary care providers in 50 states and the District of Columbia, serving 1.3 million PPO members.  Having access to the PPO network can mean substantial discounts in what you pay for your health care, even before you meet your deductible.  The complete list can be viewed here (check the HumanaOne and Member radio buttons, enter your zip code and click Go.  Then select the Humana/ChoiceCare PPO Network and click Go). 

The Humana Health Insurance plans are portable, so you can move throughout the country without having to change insurance companies, and still have access to their large network.

Underwriting:

The Humana Health Insurance underwriting process is extremely fast.  Someone from their underwriting department will call you to do a telephone interview.  Often times you can be given a conditional approval during the telephone interview, if no medical records are needed.  If medical records are needed, Humana issues a decision within 48 hours after receipt of records.

One important aspect of Humana’s underwriting process is that it is done up-front only, when the application is submitted.  Many insurance companies will underwrite again when a claim is submitted, and may retroactively place a waiver on a plan if a claim occurs in the first 12 months and they determine that it was a pre-existing condition.  With Humana, if you do not receive a rate up or rider when you receive the policy, they cover the condition based on the plans benefits, and do not re-underwrite. 

Underwriting guidelines are much more lenient for plans with deductibles of $2,500 or higher.

Effective date:

If you currently have or have recently had coverage, you can request an effective date any time between the day you apply and 45 days later.  If an underwriter gives you conditional approval, your health insurance coverage can go into effect immediately.  If you have not had major medical health insurance within the past two months, you will have the choice of an effective date of 30 to 45 days after the application submission date.  

Please contact our office by phone ( 866-749- 2039) or us our contact form for more information on getting this coverage in place - right away if necessary.

Optional Benefits

Doctor Co-payment

This optional benefit allows you to purchase up to four doctor visits per year with a $25 co-payment.  If you have more than four office visits, your coverage is subject to your deductible and co-insurance.  The premium varies based on age and zip code.  Please contact us for an exact quote.

Prescription Coverage $0 Deductible

If this optional rider is chosen, no deductible is required to be met before prescription benefits are payable.  The premium varies based on age and zip code, so please contact us for an exact quote.

About Humana:

In business since 1961, Humana Health Insurance, headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies, with over 11 million medical members as of 2008, in 18 States and Puerto Rico.

Humana Health Insurance has been assigned a rating of "A-" (Excellent) from the A.M. Best Company, an independent insurance rating organization.

HSA for America is an independent authorized Humana agent.