Humana Medicare Advantage Plans Pennsylvania 2025

If you’re looking for Humana Medicare Advantage plans in 2025, you’ll want to know about the latest plan offerings and how they might fit your needs.

This succinct guide will walk you through the new plan features, cost adjustments, and the straightforward steps for enrollment. You will discover the best Medicare Advantage plans in Pennsylvania in 2025.


Key Takeaways

  • Humana offers a diverse range of Medicare Advantage plans in Pennsylvania, including HMO, PPO, and PFFS options, ensuring coverage tailored to beneficiaries’ unique health needs and preferences.


  • Beneficiaries have cost-saving opportunities through Humana’s no additional premium plans and reduced Part B premium plans, including the Medicare Giveback Benefit, which can lower monthly expenses.


  • Humana provides an array of extra benefits, notably including coverage for vision, dental, hearing, and fitness programs, enhancing overall beneficiary health and wellness in addition to basic medical needs.

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Humana’s Medicare Advantage Presence in Pennsylvania

Humana has made a significant impact in Pennsylvania as a Medicare Advantage provider by offering a broad range of plans tailored to the diverse needs of beneficiaries. The variety and flexibility of these plans set Humana apart.


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From HMO to PPO to PFFS, Humana’s Medicare Advantage plans encompass a range of options that provide a comprehensive suite of benefits.

With Humana, beneficiaries are not only receiving a high level of coverage but also enjoying high member satisfaction. Humana’s commitment to served Medicare beneficiaries is evident in its consistent efforts to improve and expand its offerings, proving its dedication to meeting the unique health needs of its members.


HMO Plans

Known for their comprehensive benefits and high customer satisfaction, Humana’s HMO Medicare Advantage plans in Pennsylvania stand out. These plans provide coverage for the same benefits as Original Medicare, and may also include coverage for:


  • Prescription drugs
  • Dental
  • Vision
  • Hearing


One of the key features of Humana’s HMO plans is the network of providers offered. Beneficiaries have access to a comprehensive network of providers, and in most cases, are required to obtain referrals to see specialists.

However, beneficiaries should be aware that using out-of-network providers, or other providers, could incur higher costs.


PPO Plans

Unlike HMO plans, Medicare Advantage HMO plans offer greater flexibility in choosing healthcare providers. Humana’s PPO Medicare Advantage plans are a popular choice.

Beneficiaries have the freedom to select any Medicare-approved doctor, as long as the provider accepts the plan’s terms and conditions. Offering Medicare Advantage plans, including HMO and PPO options, allows beneficiaries to find the best fit for their needs.

Another advantage of PPO plans is that referrals are not mandatory for accessing specialist services. Moreover, Humana’s PPO plans offer comprehensive coverage, including Medicare Parts A and B benefits, prescription drug coverage, and routine dental, vision, and hearing benefits.


PFFS Plans

For those seeking the convenience of consolidating their Medicare benefits into a single plan, Humana’s PFFS Medicare Advantage plans are a great option. These plans offer the same coverage as Original Medicare, with the added benefit of a Gold Choice Medicare plan.

One of the key features of Humana’s PFFS plans is the flexibility to visit any Medicare-approved provider, as long as they agree to the plan’s terms and conditions. However, beneficiaries should be aware of the potential expenses associated with these plans.


Premiums and Cost-Sharing

Humana is committed to making healthcare more affordable for beneficiaries. This commitment is reflected in its offerings of no additional premium plans and reduced Part B premium plans.

By providing plans with no additional premium beyond the standard Part B premium, Humana ensures that beneficiaries can access necessary healthcare without worrying about extra costs.

On the other hand, Humana’s reduced Part B premium plans provide an opportunity for eligible beneficiaries to save on their standard Part B premium, making coverage even more affordable.


No Additional Premium Plans

Humana’s no additional premium plans are designed to provide comprehensive coverage without any extra costs beyond the standard Part B premium.

These plans not only offer coverage for dental, vision, and hearing but also include benefits like the Healthy Living Program and access to CenterWell health care services. The specific coverage of a Humana plan depends on the chosen plan and its benefits.

However, while these plans do not have extra premiums, it’s important for beneficiaries to understand that there may be other associated costs and certain terms that could impact the continuity of coverage. This underscores the importance of thoroughly understanding all terms and conditions before enrolling in a plan.


Reduced Part B Premium Plans

A unique feature of Humana’s reduced Part B premium plans is the Medicare Giveback Benefit, which allows eligible beneficiaries to reduce their standard Medicare Part B premium. This benefit can result in potentially lower monthly expenses, making healthcare coverage more affordable for beneficiaries.

These plans also offer comprehensive benefits, including coverage for Medicare Parts A and B, prescription drug coverage, and routine dental, vision, and hearing benefits. Moreover, beneficiaries can enjoy access to lower-cost preferred pharmacies, further enhancing the affordability of these plans.


Extra Benefits Offered

In addition to the standard benefits, Humana’s Medicare Advantage plans in Pennsylvania also offer a host of extra benefits, including:


  • Vision coverage
  • Dental coverage
  • Fitness benefits
  • Hearing benefits


Humana Insurance Company goes above and beyond to ensure beneficiaries receive comprehensive care through their Humana insurance services.

These extra benefits not only enhance the value of Humana’s Medicare Advantage plans but also contribute to the overall well-being of Medicare Advantage members. After all, healthcare is not just about treating illnesses; it’s about promoting overall health and wellness.


Vision Benefits

Humana’s vision benefits are designed to provide comprehensive coverage for your eye health needs. From annual eye exams to coverage for eyeglasses or contact lenses, Humana ensures that beneficiaries have access to the vision care they need.

The vision benefits from Humana also include a frame allowance every 24 months and discounts on frames and contact lenses. However, it’s important to note that these benefits are subject to certain restrictions and inclusions.


Dental Benefits

Another key component of Humana’s Medicare Advantage plans is the comprehensive dental benefits.


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These benefits include coverage for preventive dental care such as annual dental exams, two complimentary cleanings per year, and dental X-rays once every 5 years. Beneficiaries can also enjoy potential savings on a range of dental procedures through dental discounts provided by the Dental Savings Plus plan and dental discount cards.

However, it’s important to note that coverage for orthodontic procedures may be subject to certain restrictions such as age limits.


Fitness and Hearing Benefits

Promoting physical fitness and hearing health among its beneficiaries is a priority for Humana. Hence, it offers the SilverSneakers fitness program at no additional cost. This program provides members with a range of indoor and outdoor workout options, fitness equipment, and classes suitable for all fitness levels.

In addition to fitness benefits, Humana also provides comprehensive hearing benefits. These include substantial hearing aid savings and complimentary batteries with the purchase of hearing aids. Beneficiaries can easily utilize these benefits by enrolling in any of the 2025 plans.

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Prescription Drug Coverage

Prescription drug coverage is a crucial aspect of Humana’s Medicare Advantage plans. With a systematic grouping of drugs into different tiers, Humana ensures that beneficiaries can access necessary medications at varying price levels.

In addition to tiered pricing, Humana also offers preferred pharmacy options. By utilizing preferred pharmacies, beneficiaries can enjoy reduced prescription costs, making medication more affordable.


Drug Tiers and Pricing

The drug tier system from Humana categorizes drugs into various pricing levels. This tiered system influences the cost-sharing for prescription medications and can result in substantial savings for beneficiaries.


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To determine the coverage and pricing for specific drugs, beneficiaries can utilize the search tools provided by Humana or refer to the Drug Formulary specific to their Part D plan.

By doing so, beneficiaries gain clarity on the expenses linked to various drug tiers, empowering them to make informed decisions about their healthcare.


Preferred Pharmacies

Humana’s preferred pharmacies offer an opportunity for beneficiaries to reduce their out-of-pocket costs for prescription medications. Choosing a preferred pharmacy allows beneficiaries to enjoy lower prescription costs, thus making their medications more affordable.

Preferred pharmacies are included in some of Humana’s Medicare Advantage Plans. To locate a preferred pharmacy, beneficiaries can utilize the comprehensive retail network provided by Humana, which consists of over 60,000 pharmacies.


Rural Areas and Special Needs Plans

Humana makes a significant effort to cater to beneficiaries residing in rural areas and those with specific needs. With tailored plans for rural areas and Dual Eligible Special Needs Plans for beneficiaries eligible for both Medicare and Medicaid, Humana ensures that all beneficiaries can access the care they need.

Humana’s rural area coverage extends to 90% of rural areas in Pennsylvania, ensuring that beneficiaries in less populated areas can access necessary healthcare.


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On the other hand, Humana’s Dual Eligible Special Needs Plans provide custom benefits to meet the needs of those with dual eligibility, further enhancing the inclusivity of Humana’s Medicare Advantage plans.


Rural Area Coverage

Beneficiaries residing in Pennsylvania’s rural areas can access the care they need through Humana’s comprehensive rural area coverage. From regular dental, vision, and hearing benefits to expanded plan options, Humana ensures that rural beneficiaries have access to comprehensive and affordable health plan options.

However, beneficiaries in rural areas may face certain obstacles when trying to access Medicare Advantage plans. By enhancing the affordability of healthcare for rural beneficiaries, Humana addresses these obstacles and ensures that all beneficiaries, regardless of their location, can access necessary healthcare.


Dual Eligible Special Needs Plans

Providing customized benefits to meet specific needs, Humana’s Dual Eligible Special Needs Plans (D-SNPs) cater to individuals who qualify for both Medicare and Medicaid. These plans offer coordinated Medicare and Medicaid benefits, along with additional benefits such as dental, vision, and hearing coverage.

To qualify for a D-SNP, individuals must meet certain eligibility criteria, including:


  • being a U.S. citizen or a lawful permanent resident
  • qualifying for Original Medicare
  • meeting the financial requirements for the state’s Medicaid program
  • residing in an area where D-SNPs are available


By providing these specialized plans, Humana ensures that those with dual eligibility can access the comprehensive care they need.

Enrollment Process and Contract Renewal

The process of enrolling in a Humana Medicare Advantage plan is straightforward, requiring just your personal information and your government-issued Medicare card. Once enrolled, contract renewal typically occurs automatically, ensuring that beneficiaries can continue to enjoy their benefits without interruption.

Beneficiaries should, however, review their plan annually to ensure it still fits their needs. During the open enrollment period, beneficiaries have the option to change their plan or make adjustments to their existing plan.


How to Enroll

To enroll in a Humana plan, individuals can start by selecting their desired plan and completing the enrollment form with their personal information. Beneficiaries can either enroll online, over the phone, or with the assistance of a licensed agent, making the enrollment process convenient and flexible.

However, it’s important to note that certain eligibility criteria must be met to enroll in a Humana plan.

These include being 65 years of age or older, being younger than 65 with a qualifying disability, or having ESRD. It is also worth mentioning that eligibility is not determined by factors such as national origin age disability sex, disability sex sexual orientation, or expression transgender status marital.


Contract Renewal

Contract renewal for Humana’s Medicare Advantage plans typically occurs automatically on an annual basis, ensuring a seamless continuation of coverage for beneficiaries.

However, it’s important for beneficiaries to review any changes to their medicare contract during the open enrollment period and make any necessary adjustments.

Failure to enroll during the open enrollment period could result in Medicare late enrollment penalties and higher monthly premiums for Part B and Part D coverage.


With a wide range of plan options, comprehensive coverage, and additional benefits, Humana’s Medicare Advantage plans offer a robust solution for beneficiaries in Pennsylvania.

Whether you’re in a rural area, have dual eligibility, or are just looking for a plan that fits your needs, Humana has you covered. As we look forward to 2025, it’s clear that Humana’s commitment to providing high-quality, affordable healthcare continues to set them apart in the Medicare Advantage landscape.

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Frequently Asked Questions


What is new for Humana 2025?

In 2025, all Humana Medicare Advantage plans will include dental, vision, and hearing benefits. Be sure to compare the plans in your area to find the best option for you.


How much is Humana OTC allowance for 2025?

Humana provides a $100 quarterly allowance for over-the-counter health and wellness products through their OTC Mail Order service. Any unused amount expires at the end of the quarter.


Who has the best Medicare Advantage plans for 2025?

The best Medicare Advantage plans for 2025 are offered by UnitedHealthcare and Humana, providing a good balance between quality coverage, affordable costs, and additional benefits. Both companies are popular choices for different reasons.


Why are people leaving Medicare Advantage plans?

People are leaving Medicare Advantage plans due to excessive prior authorization denial rates and slow payments from insurers, which are common reasons cited.


What types of plans does Humana offer in Pennsylvania?

In Pennsylvania, Humana offers HMO, PPO, and PFFS Medicare Advantage plans, providing a range of options for coverage.

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Compare Medicare Plans

Find a plan to fit your needs


Speak with a licensed insurance agent

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