This website is for individual Medicare coverage only.
Humana is a Medicare Advantage HMO, PPO and PFFS organization and a stand-alone prescription drug plan with a Medicare contract. Humana is also a Coordinated Care plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in any Humana plan depends on contract renewal.
If your plan has a network
You must use plan providers except in emergency or urgent care situations or for out-of-area renal dialysis. If you obtain routine care from out-of-network providers neither Medicare nor Humana will be responsible for the costs.
For PPO plans
With the exception of emergency or urgent care, it will cost more to get care from out-of-network providers. Additionally, accessing services from in-network providers can cost less than using services of out-of-network providers.
If benefits for which the coinsurance percentage is the same both in and out of network, member responsibility will be greater out of network when the out-of-network coinsurance is based on the Medicare allowed amount and the contracted amount is lower.
The plan provides reimbursement for all covered benefits regardless of whether they are received in network, as long as they are medically necessary.