Wellness

[hoosieroriginal]

I think I have finally found a plan with Humana - but before I sign up, I would like to know if anyone has any good or bad experiences with Humana (I hope you aren't all sick of me by now, but you are all my support system at this point!)  Thanks in advance. 

[henderson]

I have Sr. Dimensions, Health Plan of Nevada.  Someone I know has Humana and she gets a free gym membership.  Both our plans do and I see her at water aerobics at 24 Hr. Fitness.  I think she has the PPO plan. 

[Perkup]

I have Blue Cross myself and have had it for years.  But my DH who passed last August was covered by Humana.  He chose the plan which has no monthly premium.  This plan covered portions of his dental needs as well as vision, and offered some sort of fitness/exercise benefits which he didn't use.  The dental plan paid for one cleaning a year and I believe annual x-rays , plus additional care benefits for fillings, etc..  He had a co-pay for office visits, a perk that is covered in their paid plan (somehow a monthly payment of $69.00 sticks in my mind, but not sure.) Most co-pays were in the range of $20.00, but had gone up slightly during the last year or so - some specialists co-pays were $40.00 per visit.

He spent many weeks in the hospital during the last 18 months of his life, and almost everything was covered 100%. He also had Medicare of course; we received no bills for any of his hospital stays or other medical care.  Overall, he was highly pleased with Humana and stayed with them for a number of years. At first he checked into other plans, but never left Humana.  I wish I could tell you more.

[BLH]

I would not recommend that you get Humana.  I work at a provider's office and anytime I call i am speaking to someone in the Phillipines.  Check with all of your doctors and hospitals first.  Alot of places don't take it.  I would recommend you stick with Medicare and a supplement.  You can walk into any doctor or hospital in this country with medicare.  Also you get to speak to an American.

[m0rgan]

I had humana and it is great as long as you stay in network.  If you go out of network it seemed to me that they always deny payment, then you have to ask them to take another look, then they deny payment again.  If you fill out the appeals form, then they pay.  This was because my doctor didn't do insurance and I had to send it in myself and pay the doctor when I was there.  I was asking to be repaid for money I paid the doctor.  Not sure why, except they may not know how to handle out of network payments submitted by patients.  It happened to me at least 6 times but I wouldn't let them get away with it and finally got my money.  It just takes time and persistance.  My husband went into the hospital and everything was paid quickly.  There were some out of network doctors and they were also paid and the remaining balance sent to us.  No issues.

[KathyPet]

JUst be sure you understand what your potential costs would be if for any reason you go "out of network".  My husband had Medicare A and B plus the AARP Plan F supplement.  HE was diagonised with a brain tumor.  THe symptoms were very sudden and things went very bad, very fast.  WIthin Two days of the first symptoms he had a MRI and was put on a helicopter to UVA Medical Center with a breathing tube.  THe top Neuro oncologist in our entire area was at UVA and they were the top of the line for this type of cancer.  HE underwent a Brain biopsy and multiple other tests.  TWo rounds of 7 day in hospital chemo took place over the next two months,followed by being transported back up here for short stays in a local nursing home before being returned to UBA for another round of chemo.  PRior to starting his third chemo round he contracted a lung infection from which he never recovered. He was moved to the UVA transitional hospital and spent two months there before he died.  HE spent a total of almost 100 days in the hospital and 15 days in nursing homes.  THe "sticker price" for all this topped a million dollars.  My out of pocket cost  were $800 for a post chemo drug that he needed to be given in the nursing home for several days after he left the hospital starting right away.  THis drug is very rare and not easily obtainable so I got it at the UVA pharmacy and took it with me when we brought him to the nursing home.

My point with this story is that I did not have to worry or concern myself with whether a hospital or any of the many doctors were in or out of my network.  I could go to any hospital and have any specialists treat him with no thought as to whether the cost would be covered.  THings like this do happen and believe me you are not going to be thinking about getting pre approvals or whether a specialist is in your network or not.  I am sure for normal medical care a Advantage plan may be fine but what happens when facing a sudden, catastrophic medical emergency?

[Zhills]

I have had Humana (employee sponsored plan) and they have always paid very well.

I take one prescriction, by choice, which cost me $80 for a 90 day supply.  I just had an illness and surgery and the total bill was $340,000.  I paid $1,000 because I took the IV antibiotics at home instead of an infusion center.  I was in a rehab center 10 days, then had an inhome nurse 3 days a week, PT and OT for another 3 weeks.  You get Silver Sneakers free at several gyms  or the Y.  I think they are very good.  My PCP visits are $5 and a specialist $20.  You do not need a referral for a specialist visit and the derm visits are 4-6 times a year.  Check it out!

My out of network is paid less, but not unreasonable.  I have no problem finding a Doctor in network.

[kittymomNC]

Prior to going on Medicare a number of years ago, I thought all doctors and hospitals accepted it, but they don't.  Doctors can choose not to accept Medicare... I had one doctor a few years ago who decided that he would no longer accept it (because of low reimbursement rates), and I had to find another doctor who  did.  My understanding is also that some hospitals have opted out of accepting Medicare - whether or not they accept the patients but just don't accept the "allowed" Medicare reimbursement as their full payment, I don't know.  But it's something you need to be aware of and check into when deciding on a plan.  I've talked to others who did not know this prior to going on Medicare.  

And personally, I have loved my regular Medicare and Supplemental policy.. there are a few drawbacks to Medicare Advantage Plans.  I've never had to pay one cent to a doctor or hospital ... the only thing I've ever paid is my premiums.  That includes a trip to the Emergency Room, overnight stay and a cardiac catheterization to the tune of a total hospital bill of $20,000 ($15,000 for the test).  I paid nothing. 

I did have Humana for my Part D prescription plan for a few years, but their premiums went so high, I changed to Silver Script (CVS Caremark) and I save between $300-400 a year.  Humana's service was okay except for a period of about 3 months during which I spent about 10 hours back and forth on the phone having a very difficult time getting my prescription refills that they had been doing for 3 years.  

[Kachina624]

I have a Humana Advantage Plan courtesy of my last employer.   It's secondary to Medicare and doesn't cost me a cent so I can't complain too much.   In my case Humana was just hired to administer an insurance programs that is actually self-insured so the money paid out doesn't come from Humana. 

I have encountered a lot of prejudice against Humana for some reason.   I've had 3 doctors and a hospital that refused to accept it.   I've had to talk to their insurance person and have her call my insurer,  who assures them that not only do they pay but pay more than most. 

Before enrolling,  I'd call hospitals and doctors in your area you might potentially use and ask them if they take Humana.   No use having it if no one will take it.