Humana Medicare Advantage Plans Maryland 2025

Are you preparing for Medicare in Maryland? Discovering the right Humana Medicare Advantage Plans in Maryland can significantly impact your healthcare journey.

This guide deciphers the variety of options and potential comprehensive benefits, directly answering your most pressing questions. Tailored for Maryland, you’ll learn precisely what you need to choose with confidence as you navigate the complexities of Medicare Advantage plans specific to your state for the forthcoming year.

 

Key Takeaways

  • Humana Medicare Advantage plans in Maryland offer a range of options, including HMO, PPO, and PFFS plans to meet various healthcare needs and budgets, with possible benefits like vision, dental, and hearing care.

 

  • Based off data from previous years, nearly 94% of Humana Medicare Advantage members have been enrolled in plans and rated 4 stars and above by CMS, with four contracts receiving a 5-star rating, demonstrating Humana’s commitment to quality healthcare and customer satisfaction.

 


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Humana Medicare Advantage Plans in Maryland

 

Humana Medicare Advantage Plans Maryland 2025 Humana Medicare Advantage Plans in Maryland 2025

 

Humana’s Medicare Advantage plans are likely to stand out due to their meticulous design, aimed at serving the diverse needs of Medicare beneficiaries. With an impressive array of plan types, Humana will likely ensure that Medicare Advantage members may be able to find a plan that aligns with their specific healthcare needs and budget constraints.

Whether you’re seeking a plan with a broad network, prefer a specific provider, or need flexibility in provider choice, Humana’s plans could accommodate these preferences. The plethora of options, from Health Maintenance Organization (HMO) to Preferred Provider Organization (PPO) and Private Fee-for-Service (PFFS) plans, cater to a wide spectrum of healthcare needs and lifestyles.

 

Plan Types

Humana’s Medicare Advantage HMO plans are an excellent choice for individuals who prefer a network of healthcare providers.

By selecting a primary care physician to manage care, members can enjoy a coordinated approach to healthcare, which is a hallmark of HMO plans. Additionally, those interested in exploring other options may consider Medicare Advantage HMO PPO plans for added flexibility.

On the other hand, Humana’s PPO plans offer greater flexibility, allowing members to see providers both within and outside the network. While out-of-network services may incur higher out-of-pocket costs, the flexibility is a significant advantage for those who require more provider options, and the right Humana plan depends on individual needs.

For individuals seeking the utmost flexibility, Humana’s PFFS plans allow members to choose any Medicare-approved healthcare provider who agrees to the plan’s payment terms and conditions.

 

Key Features

 

Humana Medicare Advantage Plans Maryland 2025 Humana Medicare Advantage Plans in Maryland 2025

 

Humana Insurance Services’ Medicare Advantage plans, also known as Humana Plan, may go beyond matching the coverage offered by Original Medicare. Some of these plans may exceed expectations by possibly providing additional benefits that could cater to the holistic health and wellness needs of their members in collaboration with Centerwell Health Care Services.

Some of these potential benefits could include coverage for vision, dental coverage, and hearing care, proving that Humana’s commitment to their members’ health extends beyond basic medical needs. By considering the various aspects of healthcare, Humana will likely ensure that its members may receive comprehensive care that could cater to their overall well-being.

 

CMS Star Ratings and Quality Measures

When evaluating Medicare Advantage plans, CMS Star Ratings and Quality Measures serve as a reliable compass. They provide a standardized way of measuring plan performance, enabling beneficiaries to make informed decisions based on quality and service.

The CMS Star Ratings system evaluates Medicare Advantage plans on a scale of 1 to 5 stars, with 5 being the highest. This scale considers several healthcare quality measures and customer service evaluations, providing an overall assessment of the plan’s performance.

 

Humana’s Star Ratings

Humana’s commitment to quality is reflected in its CMS Star Ratings. In previous years, nearly 5.5 million, or 94% of Humana Medicare Advantage members, were enrolled in plans rated 4 stars and above. Furthermore, four of Humana’s contracts have received a 5-star rating, testifying to their exceptional service quality.

Humana’s high ratings are attributable to their focus on quality performance measures related to:

  • Health outcomes

 

  • Preventive care

 

  • Managing chronic conditions

 

  • Member satisfaction

 

  • Customer service

 

Although some of the specific details on their ratings in Maryland for 2023 are unavailable, Humana’s consistent performance nationally emphasizes on their service quality.

 

Quality Measures

Quality measures used by CMS aim to evaluate healthcare processes, outcomes, and patient perceptions. By focusing on care that is:

  • Effective

 

  • Safe

 

  • Efficient

 

  • Patient-centered

 

  • Equitable

 

  • Timely

 

These measures help ensure that Medicare Advantage plan members to receive optimal care. Humana’s impressive performance in the CMS Star Ratings system is a testament to its commitment to high-quality healthcare and customer satisfaction.

In Maryland, policy developments and recommendations, such as those related to telehealth, are driven by studies from organizations like MHCC. These efforts underscore the importance of virtual care and appropriate payment models for telehealth services, aligning with Humana’s commitment to innovation and accessibility in healthcare.

 

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Potential Costs and Coverage

 

Humana Medicare Advantage Plans Maryland 2025 Cost and Coverage Details

 

Grasping the details of cost and coverage in Medicare Advantage plans is a key step in making a well-informed decision.

When striving for the best possible coverage, it’s vital to weigh the numerous financial aspects alongside the array of benefits offered. Some of Humana’s plans may feature lower deductibles, potentially adding to the overall value proposition.

These economic factors, coupled with the plan’s features and benefits, could steer your decision-making process while selecting a Medicare Advantage plan.

 

Potential Copays and Deductibles

Humana also offers Dual Eligible Special Needs Plans (D-SNPs) for individuals qualified for both Medicare and Medicaid.

Certain Humana Medicare Advantage plans may provide a flexible annual allowance to assist members with out-of-pocket costs that could cover dental, vision, or hearing services – a testament to Humana’s commitment to comprehensive and affordable care.

 

Provider Network and Pharmacy Options

 

Humana Medicare Advantage Plans Maryland 2025 Provider Network and Pharmacy Options

 

A vital element of every Medicare Advantage plan is the accessibility of provider networks and pharmacy options for members. Humana’s pharmacy network in Maryland could potentially include limited lower-cost, preferred pharmacies in urban areas, and possibly ensuring affordable access to medications for members.

While the specific details regarding the size and scope of Humana’s provider network in Maryland are not available currently due to the 2025 plans not being released yet, the focus should be on the breadth and quality of providers. By checking back to this website, you can find updated information about the 2025 plans.

Opting for a plan with a network that aligns with your healthcare needs and preferences is an important move towards guaranteeing the best possible healthcare results.

 

Provider Network

Choosing a Medicare Advantage plan involves careful consideration of the provider network. While specific details regarding the size and scope of Humana’s provider network in Maryland are not currently available, it’s important to remember that the quality of care is as important as the quantity of providers.

Whether you prefer a specific provider or require the flexibility to choose from a broad network, some of Humana’s diverse plan types could accommodate those preferences. By ensuring that your healthcare providers are part of the Humana network, you are likely to enjoy seamless access to care without worrying about out-of-network costs from other providers.

 

Potential Pharmacy Options

Pharmacy options are a critical factor to consider when choosing a Medicare Advantage plan. Some of Humana’s pharmacy network in Maryland will likely include over 60,000 pharmacies, potentially ensuring wide accessibility to prescription drugs for Medicare Advantage members. Within this unified network, members could also have access to preferred cost-share pharmacies.

In certain areas of Maryland, members may be able to opt for limited lower-cost preferred pharmacies. This flexibility in pharmacy options, combined with Humana’s comprehensive prescription drug plans, will likely ensure that members can manage their health without worrying about the accessibility or affordability of their medications.

 

Possible Benefits and Services

 

Humana Medicare Advantage Plans Maryland 2025 Additional Benefits and Services

 

Humana’s Medicare Advantage plans in Maryland, operating under a Medicare contract, may go beyond standard medical coverage and potentially offer additional benefits that could be aimed at improving health and wellness for served Medicare beneficiaries. Some of these possible services, including Medicaid services, could consist of an over-the-counter medication allowance and transportation benefits, which might help members manage their health and access healthcare facilities for their medical appointments.

These potential supplementary benefits are likely to embody Humana’s all-encompassing approach to healthcare. By tackling determinants that shape health outcomes, such as adherence to medication and care accessibility, Humana could  allow their members receive exhaustive support in health management

 

Telehealth Services

In the digital age, healthcare services are no longer confined to traditional settings. Telehealth services, included in Humana’s Medicare Advantage plans, allow members to consult with healthcare professionals remotely via audio-visual communication tools.

In Maryland, Humana’s telehealth services align with the state’s initiatives to promote access to virtual care. The telehealth options support the use of both audio-only and audio-visual technologies for a variety of health services, including somatic and behavioral health.

These services help overcome barriers to accessible and timely healthcare, enhance care coordination, and expand medical services to Health Professional Shortage Areas.

 

Enrollment and Eligibility

The last mile in your quest for the best Medicare Advantage coverage is comprehending the enrollment process and pertinent eligibility criteria.

Eligibility for enrolling in a Humana Medicare Advantage Plan includes having both Medicare Part A and Part B, residing in the plan’s service area, and not having end-stage renal disease, with certain exceptions. It’s crucial to take into account these prerequisites and the timeline in the enrollment process to guarantee a seamless shift to your selected plan.

 

Enrollment Process

Enrolling in a Humana Medicare Advantage plan involves specific timing and processes. The initial enrollment period (IEP) is a seven-month window that begins three months before the year you turn 65, includes the year you turn 65, and ends three months after the year you turn 65. If you’re under 65 and receive Social Security Disability Insurance (SSDI), you qualify for Medicare and the IEP after a specific period.

Another key enrollment time is the Annual Election Period (AEP), which runs from October 15 to December 7 each year. During this time, you can change your Medicare Advantage or prescription drug plan for the following year, making it an ideal time for contract renewal.

Additionally, Special Enrollment Periods (SEPs) allow for plan changes under certain circumstances, such as:

  • moving out of the service area

 

  • losing current coverage

 

  • being diagnosed with certain conditions, like amyotrophic lateral sclerosis (ALS) or end-stage renal disease (ESRD)

 

People in these situations are granted SEPs for plan enrollment.

 

Eligibility Requirements

To be eligible for Humana Medicare Advantage plans in Maryland, individuals must have both Medicare Part A and Part B. This ensures that you have hospital and medical coverage, which is crucial for comprehensive care.

Apart from having Parts A and B, enrollees must also reside in the service area of the plan they wish to join. This is to ensure that you have access to the providers and services covered by the plan.

Lastly, applicants cannot have end-stage renal disease (ESRD), with some exceptions. Understanding these eligibility requirements, including those related to national origin, age disability, and sex, is key to a smooth enrollment process and optimal healthcare experience.

 

Summary

Choosing a Medicare Advantage plan is a crucial decision that impacts your health, well-being, and financial stability. Humana’s Medicare Advantage plans in Maryland, with their diverse plan types, impressive CMS Star Ratings, potential comprehensive coverage details, provider network and pharmacy options, and possible benefits, could provide a robust solution for your healthcare needs.

Remember to consider the enrollment process and eligibility requirements when choosing a plan. With this comprehensive guide, you’re well-equipped to make a decision that aligns with your healthcare needs and lifestyle preferences.

 


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Frequently Asked Questions

 

What is new with Humana in 2025?

The plans for 2025 have not been released yet, but make sure to check this website for additional information and updates.

 

Is Humana Medicare Advantage available in Maryland?

Yes, Humana may offer Medicare Advantage plans and potential prescription drug coverage in Maryland, which may give residents an alternative way to get their Original Medicare. With a total of 28 Medicare Advantage plans available in the state from various companies, including Humana, individuals have a range of options to choose from.

 

What types of plans does Humana offer in Maryland?

Humana offers a variety of Medicare Advantage plans in Maryland, including HMO, PPO, and PFFS plans. Consider exploring these options to find the best fit for your needs.

 

How does CMS evaluate Humana’s Medicare Advantage plans?

CMS evaluates Humana’s Medicare Advantage plans using a Star Ratings system, which considers healthcare quality measures and customer service evaluations. This system helps to assess the overall performance of these plans.

 

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