Humana Medicare Advantage Plans Kansas 2025

Looking for insight on Humana Medicare Advantage plans Kansas 2025? Cut through the complexity with this clear guide on plan options, costs, and enrollment details specific to Kansas.

Whether you’re drawn to HMOs, PPOs, or require Special Needs Plans, we’ve got the up-to-date information that will empower your choice—ensuring you’re well-equipped to navigate the year ahead with confidence.

 

Key Takeaways

  • Humana offers a variety of Medicare Advantage plans in Kansas, such as HMO, PPO, and Special Needs Plans (including D-SNPs), each designed to cater to different healthcare preferences and needs.

 

  • Humana Medicare Advantage plan costs depend on multiple factors, including the type of plan, prescription drug coverage, cost-sharing requirements, potential out-of-pocket maximums, and additional premiums, which can vary across Kansas.

 

  • Medicare beneficiaries can enroll in Humana plans during the Initial Enrollment Period around their 65th birthday or during the Annual Election Period from October 15 to December 7, with benefits from changes effective as of January 1 of the following year.

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Understanding Humana Medicare Advantage Plans in Kansas

 

Humana Medicare Advantage Plans Kansas 2025 Understanding Humana Medicare Advantage Plans in Kansas

 

Humana Insurance Company is a Medicare contract holder that offers a variety of Medicare Advantage plans in Kansas, providing a spectrum of health coverage options for beneficiaries through their Humana Insurance Services. These plans include Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), and Special Needs Plans among others, each catering to different healthcare needs.

To make an informed decision about your healthcare, understanding the specifics of these Medicare Advantage plans is crucial, as your ideal Humana plan depends on your individual needs and preferences.

Special Needs Plans, for instance, are tailored to meet specific health needs, offering targeted healthcare solutions for eligible individuals. These plans, like others under the Humana umbrella, are designed to ensure that beneficiaries receive care that is customized to their needs, promoting optimal health outcomes.

 

Medicare Advantage HMO vs PPO

When choosing a Medicare Advantage plan, understanding the differences between HMO and PPO plans, including Medicare Advantage HMO PPO options, can be instrumental in selecting a plan that best suits your healthcare needs.

Humana’s Medicare Advantage HMO plans in Kansas have network restrictions, requiring members to use healthcare providers within the plan’s network to maintain the lowest costs and necessitating primary care physician referrals for specialist care.

On the other hand, Humana’s PPO plans provide greater flexibility, allowing members to see any provider that accepts the plan and use both in-network and out-of-network providers without a referral.

However, out-of-network services generally come at a higher out-of-pocket cost. The choice between the HMO and PPO plan depends on your healthcare needs and budgetary considerations, emphasizing the importance of understanding the intricacies of each.

 

Dual Eligible Special Needs Plans

For individuals who are eligible for both Medicare and Medicaid, Humana offers Dual Eligible Special Needs Plans (D-SNPs) in Kansas. These plans aim to provide more coordinated care and additional benefits tailored to their specific needs.

To enroll in a Humana Dual Eligible Special Needs Plan, an individual must be entitled to Medicare Part A, enrolled in Medicare Part B, and be receiving some form of Medicaid benefit.

Humana’s D-SNPs in Kansas may include additional benefits such as personalized care coordination, transportation services to medical appointments, and allowances for over-the-counter health products. These comprehensive services help ensure that dual-eligible beneficiaries receive the care they need seamlessly and efficiently.

 

Stand-Alone Prescription Drug Plans

Humana offers stand-alone prescription drug plans (PDPs) in Kansas that supplement the coverage for medications not included in Medicare Advantage plans. These plans can complement Original Medicare or work alongside Medicare Advantage plans that do not include drug coverage, providing a much-needed safety net for beneficiaries who need specific medications.

These PDPs from Humana offer the following benefits:

  • Cover a wide range of medications

 

  • Allow beneficiaries to choose from different plans with varying levels of coverage and cost-sharing

 

  • Include a variety of tiers offering varying costs for generics and brand-name medications, catering to diverse prescription needs.

 

Coverage and Cost Considerations

 

Humana Medicare Advantage Plans Kansas 2025 Coverage and Cost Considerations

 

The cost of Humana Medicare Advantage plans in Kansas is influenced by several factors, including:

  • The plan type selected

 

  • Whether the plan includes prescription drug coverage

 

  • Cost-sharing requirements

 

  • Potential for out-of-pocket maximums, which cap annual spending for covered services within the network

 

  • Additional premiums, such as the Medicare Part B premium and any applicable Optional Supplemental Benefit (OSB) premiums

 

These costs could vary depending on the beneficiary’s location within Kansas.

It’s important to be aware that out-of-network or non-contracted providers are not obligated to treat Humana Medicare Advantage members except in emergency situations. This can have financial implications and should be considered when choosing a plan.

 

Lower Cost Preferred Pharmacies

Humana’s pharmacy network includes lower-cost, preferred pharmacies available in urban, suburban, and rural areas across Kansas. By utilizing preferred pharmacies in Humana Medicare Advantage plans, members can benefit from lower co-payments on prescription medicines.

Preferred pharmacies may offer medications at prices lower than non-preferred pharmacies due to agreements to provide lower prices for plan members. However, the availability of these pharmacies can be limited in some urban areas.

To find a convenient, lower-cost preferred pharmacy in their area, Humana members are recommended to use the online pharmacy directory on Humana.com.

 

Benefits Vary by Location

Humana Medicare Advantage plans have costs, coverage, and benefits that vary by location and are not available in all areas. The variation in benefits by location can include:

  • Differences in available providers

 

  • Differences in available pharmacies

 

  • Differences in specific plan options

 

  • Limitations on services such as virtual visit healthcare can differ by state and affect the benefits available to beneficiaries in different locations.

 

The specific health services and benefits covered by Humana Medicare Advantage plans can vary by county within Kansas. Specialized programs or additional benefits, such as wellness programs or dental and vision coverage, may also differ based on location.

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Navigating the Humana Network

 

Humana Medicare Advantage Plans Kansas 2025 Navigating the Humana Network

 

Beneficiaries can access current information about Humana’s network pharmacies, including lower-cost preferred pharmacies in specific areas, by consulting Humana’s online pharmacy directory or contacting customer service.

It’s reassuring to know that CMS’s oversight includes network adequacy reviews for Medicare Advantage plans. This ensures regulatory requirements and standards are met, which is crucial for the accessibility of healthcare providers within the Humana network.

 

Other Providers

Humana Medicare Advantage plan members can choose from a wide range of healthcare providers within the Humana network, including:

  • Physicians

 

  • Specialists

 

  • Pharmacies

 

  • Labs

 

 

This network extends beyond just pharmacies to include various providers, ensuring that members have access to comprehensive healthcare services.

This wide range ensures that beneficiaries have access to comprehensive care services, contributing to an overall better healthcare experience by putting health first.

 

Enrollment and Contract Renewal

Organizations interested in offering Medicare Advantage plans, including becoming a PFFS organization, must:

  • Submit an application to obtain a Medicare Advantage contract with Medicare

 

  • Specifically for plan types such as HMO/HMO-POS, PPO, RPPO, PFFS, MSA, EGWP, and SNP

 

  • Part of the application process includes submitting a payment information form to CMS

 

  • Prospective plan applicants can join the HPMS listserv to receive important communications from CMS about the Medicare Advantage and Part D programs.

 

The renewal process for Medicare Advantage plans involves meeting specific Medicare requirements and standards to maintain the contract for plan offerings. If a Medicare Advantage plan does not have its contract renewed, members must select a new plan during the subsequent enrollment period.

Medicare Advantage beneficiaries receive notifications about the renewal status of their plan and if they need to take action, ensuring they are informed of any changes. CMS keeps beneficiaries and plan providers up to date with weekly updates to the HPMS listserv and by publishing HPMS memos on their public website.

 

Initial Enrollment Period

The Initial Enrollment Period for Medicare is a 7-month window surrounding an individual’s 65th birthday. It starts three months before the month of their 65th birthday, includes the birthday month, and ends three months after.

This period is a crucial time for individuals about to turn 65 to start thinking about their healthcare options.

Medicare Part A coverage typically starts the month an individual turns 65 unless their birthday is on the first of the month, in which case coverage begins the month before. Medicare Part B coverage begins the month someone turns 65 if they enroll before that month; otherwise, it starts the following month if they sign up during their birthday month or within the three months thereafter.

 

Annual Election Period

The Annual Election Period (AEP) for Medicare Advantage and Medicare prescription drug coverage runs from October 15 to December 7 each year. Changes made during the AEP take effect on January 1 of the following year.

This period is an opportunity for Medicare beneficiaries to review their health plans and prescription drug coverage and make changes if necessary.

During the AEP, Medicare beneficiaries can:

  • Change their Medicare health plans

 

  • Change their prescription drug coverage for the following year

 

  • Switch from Original Medicare to a Medicare Advantage plan

 

  • Change from one Medicare Advantage plan to another

 

  • Drop their Medicare Advantage plan and return to Original Medicare

 

These changes can be made during the AEP.

Nondiscrimination and Accessibility

Humana ensures that individuals are not excluded or treated differently due to any particular characteristic when accessing healthcare services. Protected characteristics under Humana’s non-discrimination policy include:

  • Race

 

  • Color

 

  • National origin

 

  • Age

 

  • Disability

 

  • Sex

 

  • Religion

 

This commitment to non-discrimination underscores Humana’s dedication to promoting health equity and access for all.

 

Free Language Interpreter Services

To support effective communication between beneficiaries and healthcare providers, Humana provides free language interpreter services. This service is part of Humana’s commitment to accessibility, ensuring that language barriers do not impede beneficiaries from accessing healthcare services and communicating effectively with providers.

This commitment to inclusivity is an essential part of Humana’s dedication to serving its diverse member base.

 

Military Service Personnel and Veteran Status

Humana upholds Federal civil rights laws and maintains a strong policy against discrimination, including safeguards for military or veteran status. Under its non-discrimination policy, Humana has made a clear commitment to providing equal healthcare access to individuals with military or veteran status.

Humana actively supports military service personnel and veterans by ensuring equal treatment and non-discriminatory access within their Medicare Advantage plans. This commitment reflects Humana’s dedication to honoring those who have served by ensuring they receive the healthcare they deserve, including serving Medicare beneficiaries.

Summary

In conclusion, understanding the specifics of Humana Medicare Advantage plans in Kansas is essential in making an informed healthcare decision.

Whether you’re comparing HMO and PPO plans, considering Dual Eligible Special Needs Plans or Stand-Alone Prescription Drug Plans, or navigating through coverage and cost considerations, this knowledge can empower you to choose a plan that best suits your healthcare needs. Remember, healthcare is a personal journey, and the best plan is one that aligns with your unique health needs and financial considerations.


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Frequently Asked Questions

 

What is new with Humana in 2025?

In 2025, Humana Medicare Advantage plans now offer dental, vision, and hearing benefits, providing enhanced coverage for members seeking comprehensive care.

 

What is the deductible for Humana in 2025?

In 2025, the deductible for Tier 3, Tier 4, and Tier 5 drugs with Humana is $545, while Tier 1 and Tier 2 have a $0 deductible. You pay the full cost of drugs in Tiers 3, 4, and 5 until you reach the deductible, after which you only pay your cost-share.

 

How do Humana Medicare Advantage plans differ from Original Medicare?

Humana Medicare Advantage plans combine Part A and Part B coverage and often include additional benefits like dental, vision, and prescription drug coverage, which Original Medicare does not provide. These plans may also have network restrictions and vary in cost.

 

What is the difference between Humana’s HMO and PPO plans?

In conclusion, Humana’s HMO plans require the use of in-network providers and referrals for specialist care, while PPO plans offer more flexibility in choosing providers and accessing out-of-network services. It’s important to carefully consider your healthcare needs when choosing between the two.

 

Who is eligible for Humana’s Dual Eligible Special Needs Plans in Kansas?

Individuals who are eligible for both Medicare and Medicaid are eligible for Humana’s Dual Eligible Special Needs Plans in Kansas.

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Speak with a licensed insurance agent

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