Humana Medicare Advantage Plans Wisconsin 2025

Seeking Humana Medicare Advantage plans in Wisconsin for 2025? Discover the updated offerings, including benefits and pricing shifts, in a straightforward guide.

Find out which Humana plan aligns with your healthcare goals as we unpack the options available to Wisconsin residents in the coming year, focusing on “Humana Medicare Advantage Plans Wisconsin 2025.”

 

Key Takeaways

  • Humana has broadened its Medicare Advantage offerings in Wisconsin, including HMO, PPO, and PFFS plans, to accommodate the diverse healthcare needs of its members, with expanded coverage in both urban and rural areas.

 

  • Members enrolled in Humana Medicare Advantage plans may benefit from dental, vision, and hearing coverage, as well as flexibility in seeing providers without referrals with certain plans; costs and benefits may differ by location.

 

  • Humana’s commitment to inclusivity ensures that all members have equal access to services regardless of personal factors like race, nationality, or abilities.

 


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Understanding Humana Medicare Advantage Plans in Wisconsin

 

Humana Medicare Advantage Plans Wisconsin 2025 Understanding Humana Medicare Advantage Plans in Wisconsin

 

Humana offers an extensive array of Medicare Advantage plans to Wisconsin residents, broadening the spectrum of healthcare possibilities. From traditional Health Maintenance Organization (HMO) plans to Preferred Provider Organization (PPO) and Private Fee-for-Service (PFFS) plans, Humana is dedicated to catering to the unique needs of every beneficiary.

In 2025, Humana is expanding its HMO offerings into 140 Wisconsin counties and Medicare LPPO plans into 80 counties, underscoring its commitment to providing a comprehensive range of healthcare solutions.

 

Medicare Advantage HMO Plans

Among Humana’s offerings are Medicare Advantage HMO plans. These plans are characterized by their requirement for enrollees to use network providers, ensuring cost-effective healthcare solutions.

As part of their HMO plan, enrollees must select a primary care physician, fostering a consistent and personal relationship between doctor and patient.

However, this type of plan typically requires referrals for specialist care, emphasizing the role of the primary care physician as a gatekeeper of healthcare services.

 

Medicare Advantage PPO Plans

For those seeking more flexibility in their healthcare choices, Humana’s Medicare Advantage PPO plans, as well as Medicare Advantage HMO PPO options, are viable alternatives. These plans offer the freedom to see any provider, whether in-network or out-of-network, without the need for a referral.

While PPO plans may come with higher premiums than HMO plans, they provide members with a more comprehensive range of provider options, giving them the freedom to choose their healthcare path.

 

Medicare Advantage PFFS Plans

Humana’s Medicare Advantage PFFS plans offer even greater flexibility than its HMO and PPO counterparts. Members of PFFS plans:

  • are not required to choose a primary care physician

 

  • do not require specialist referrals

 

  • You can see any Medicare-approved doctor or provider who agrees to the PFFS plan’s payment terms and conditions.

 

Enrollees are required to pay the Medicare Part B premium, along with their PFFS plan premium and any Optional Supplemental Benefit premium. This is an important point to keep in mind.

 

Lower Cost Preferred Pharmacies and Urban Areas

Access to lower-cost preferred pharmacies is another benefit of Humana Medicare Advantage plans. Nonetheless, one should take into account that the accessibility of these pharmacies may fluctuate based on location, especially in Wisconsin’s urban areas.

Therefore, plan members may experience variations in the availability of these pharmacies based on their specific urban, suburban, or rural areas.

For example, in Milwaukee, Humana Medicare Advantage plan members can access lower-cost preferred pharmacies. However, the specific locations and availability may vary.

Therefore, members are encouraged to check for up-to-date information regarding the locations of preferred pharmacies in their area.

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Dual Eligible Special Needs Plans

 

Humana Medicare Advantage Plans Wisconsin 2025 Dual Eligible Special Needs Plans

 

Humana also caters to individuals enrolled in both Medicare and Medicaid through its Dual Eligible Special Needs Plans (D-SNPs) in Wisconsin. As a result, beneficiaries of D-SNPs generally experience little or no out-of-pocket expenses for hospital visits, medical care, and prescription drugs under the plan.

However, to ensure their medical bills are covered, D-SNP enrollees must utilize in-network doctors and service providers. To maximize the effectiveness of D-SNPs, beneficiaries are encouraged to:

  1. Enroll in both Medicare D-SNP and Medicaid managed care organization (MCO) plans offered by the same insurer.
  2. Determine which D-SNPs are available in their county.
  3. Determine which local Medicaid plans are compatible with these D-SNPs.

By doing so, residents of Wisconsin can ensure that they have access to the necessary healthcare services and coverage.

This integrated approach reflects Humana’s commitment to providing comprehensive and coordinated care to its members.

 

Stand-Alone Prescription Drug Plans

In addition to its comprehensive Medicare Advantage plans, Humana also offers stand-alone prescription drug plans in Wisconsin. These plans serve as an alternative or supplement to traditional Medicare Advantage plans, providing coverage for a wide array of prescription medications.

The benefits of these plans can be tailored to individual needs, offering a flexible solution for medication coverage.

Members can navigate through an online pharmacy directory to identify preferred pharmacy locations and understand the applicable cost-sharing. Nonetheless, bear in mind that the provisions of stand-alone prescription drug plans may vary by location in terms of costs and coverage, and enrollment hinges on an annual contract renewal with Medicare.

Therefore, beneficiaries should verify their eligibility and understand the terms of the plan before enrolling.

 

Nondiscrimination and Inclusivity

Humana’s commitment to nondiscrimination and inclusivity is deeply rooted in its services and workforce. Humana follows Federal civil rights laws to ensure that all services are non-discriminatory and inclusive of members irrespective of various factors such as:

  • race

 

  • color

 

  • national origin

 

  • age

 

  • disability

 

This commitment aims to provide equal access and support to all individuals, regardless of their origin, age, disability, sex, marital situation, military or veteran status, or any other factors.

Humana’s dedication to diversity and inclusion is also reflected in its workforce demographics. With 75% of their employees being women, 43% being people of color, and over 30% participating in Network Resource Groups, Humana underscores its commitment to fostering an inclusive and diverse working environment.

This commitment is further bolstered by specific initiatives like the Disability Hiring Initiative, Mature Workers Initiative, and Veterans Hiring Initiative.

 

Enrollment and Contract Renewal

Joining a Humana Medicare Advantage plan involves an enrollment process that includes verifying eligibility, understanding plan options, and completing necessary paperwork during specific enrollment periods. Nonetheless, remember that enrollment in Wisconsin’s Humana Medicare Advantage plans relies on an annual contract renewal between Humana and Medicare.

The contract renewal process is integral to the continuity of healthcare coverage. It allows Humana to continue offering Medicare Advantage plans and enables current enrollees to remain in their plan for the following year, subject to the terms of the new contract.

Furthermore, default enrollment may occur for individuals getting Medicare for the first time who are also enrolled with a Social Security Income (SSI) Medicaid HMO, leading to automatic enrollment in a Medicare D-SNP offered by their current HMO.

 

Benefits Vary by Location

Despite Humana’s efforts to provide extensive healthcare coverage, remember that the availability, costs, and benefits of Humana Medicare Advantage plans in Wisconsin may differ based on location. The network of healthcare providers and pharmacies that plan members have access to varies by geographic location within Wisconsin.

The setting—urban, suburban, or rural—significantly impacts the availability of network pharmacies and cost-sharing terms for Humana Medicare Advantage plan members in Wisconsin. Moreover, state-specific regulations in Wisconsin may impose limitations on virtual visit healthcare and prescription services, affecting benefits across different regions of the state.

 

Summary

In summary, Humana Medicare Advantage plans in Wisconsin offer a comprehensive range of options designed to cater to the diverse healthcare needs of beneficiaries. From traditional HMO plans to flexible PPO and PFFS options, Humana provides Wisconsin residents with a variety of choices to find the plan that best suits their needs.

Additionally, Humana’s commitment to inclusivity, accessibility, and nondiscrimination ensures that all members can access and utilize their benefits effectively.

Whether it’s through the provision of free language interpreter services, the hiring of a diverse workforce, or the creation of plans tailored to individuals enrolled in both Medicare and Medicaid, Humana is redefining the standards of healthcare in Wisconsin and beyond.

 


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Frequently Asked Questions

 

What is new with Humana in 2025?

As of yet, the specific details for the 2025 Humana Medicare Advantage Plans have not been released. Check back later for more information.

 

What types of Medicare Advantage plans does Humana offer in Wisconsin?

Humana offers a variety of Medicare Advantage plans in Wisconsin, including HMO, PPO, and PFFS options. Each plan has distinct features and advantages. Choose the plan that best suits your needs.

 

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

HMO plans require using network providers and a primary care physician, while PPO plans offer more flexibility, and PFFS plans offer the most flexibility. Choose based on your preferred level of freedom in choosing healthcare providers.

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Compare Medicare Plans

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Speak with a licensed insurance agent

1-844-709-9937
TTY 711

Mon-Fri : 8am-9pm ET