Whether researching Humana Medigap plans or other options, many seniors find navigating the Medicare insurance system frustrating. Similarities in terminology, such as Medicare, Medicare Advantage and Medicare Supplement/Medigap, are often confusing. Many times, these terms are used ambiguously and interchangeably, when they are three totally different types of healthcare coverage.
Medicare (sometimes called Original Medicare) is the tax-funded system you become eligible to receive from the government as part of your social security benefits when you turn 65. Medicare Advantage insurance coverage is a private policy you can buy instead of using your Original Medicare benefits. Medicare Supplement insurance, or Medigap coverage, is a policy you purchase to help you pay some of the costs that aren’t covered by Original Medicare. It's called Medigap coverage because it fills the gaps in coverage provided in Medicare Parts A and B.
To qualify for a Medigap plan, you must have both Part A and Part B Medicare coverage. Medigap plans only cover one person, so spouses need to enroll separately. The insurance carrier must be licensed to sell Medigap policies in your state. Humana is licensed in all 50 states and The District of Columbia (Washington, D.C.)
The exact coverage provided by Humana Medigap plans depends on which plan you select. Humana provides a range of coverage options from copayments to coinsurance to deductibles. Depending on the plan you choose, coverage may include some, or all, of the following:
- Medicare Part A coinsurance and coverage for hospital benefits
- Medicare Part B coinsurance or copayment
- Blood (first three pints)
- Hospice Care coinsurance or copayment
- Skilled Nursing Facility Care coinsurance
- Medicare Part A deductible
- Medicare Part B deductible
- Medicare Part B excess charges
Medicare Supplement Insurance does not replace Medicare Parts A and B. It is used in concert with Original Medicare. Humana Medigap plans do not cover long-term non-skilled nursing care, vision, dental, hearing aids, private-duty nursing or prescription drugs. However, skilled nursing (nursing home) care is covered under Original Medicare and prescription drug coverage is available under Medicare Part D. Some Medigap coverage may also include foreign travel emergencies (up to the plan limits.)
Available Medigap plans vary from state to state and by location within each state. Plans A through N are standard across the board with each offering various benefits in addition to those provided by Original Medicare. Humana Medigap plans offer higher premiums and limited out-of-pocket costs for plans A through G. Plans K through N have higher out-of-pocket costs with lower premiums. Here is a breakdown of each plan:
- Plan A is a very basic plan. After you meet your deductibles, it covers coinsurance costs for Medicare Part A hospital care for an additional 365 days. Plan A also covers the cost of three pints of blood per year, Medicare Part B copayment/coinsurance costs and the Part A coinsurance/copayment costs for hospice care.
- Plan B provides the same coverage as plan A as well as covering the Medicare Part A deductible.
- Plan C covers the same benefits as plan B. This includes the Medicare Part B deductible, deductibles or coinsurance for hospitalization, skilled nursing facilities and hospital outpatient and medical expenses. It also provides payment assistance for medical emergencies that occur when you're out of the country.
- Plan F has both a high-deductible and a low-deductible option. It's considered the most complete coverage option with all the benefits of Medigap plans A, B and C.
- Plan G also has all the benefits of Medigap plans A, B, and C with the added benefit of covering 100 percent of Medicare Part B charges. It does not cover the Medicare Part B deductible.
- Plan K offers lower premium payments by paying a percentage of your costs. After you've met the annual maximum out-of-pocket amount, all charges are covered. Plan K coverage includes these benefits:
- 100 percent of Medicare Part A hospital coinsurance and, after that benefit is used, Plan K offers an additional 365 days of hospital coverage
- 50 percent of the Medicare Part A coinsurance/copayment for skilled nursing and hospice care
- 50 percent coverage of Medicare Part A deductibles
- 50 percent coverage of Medicare Part B coinsurance/copayment
- Plan L covers the same items as Plan K except at the higher rate of 75 percent instead of 50 percent. It also has a lower out-of-pocket limit than Plan K.
- Plan N requires you to pay a copay for ER visits and office visits. However, after the copay, 100 percent of Medicare Part B coinsurance costs are covered.
Because plan offerings differ from state to state, be sure to search for coverage options specific to your state of residence.
As with plan types, the costs of Humana Medigap plans can vary by location. With a Medigap plan, you pay a monthly premium to the private insurer for the Medigap coverage as well as your monthly premium to Medicare for Part B coverage. To give you an idea of plan costs, the following is a breakdown of estimated costs based on criteria for a 66-year-old male non-smoker.
|Humana Medicare Supplement (Medigap) Insurance Rates|
Average Monthly Premiums by Location
|Plan||San Francisco, CA||Kansas City, MO||Ogden, UT||Charleston, SC|
|High Deductible Plan F||$45.89||$57.51||$44.18||$53.82|
As you compare costs of different Medicare supplement plans, remember that Original Medicare doesn't cover the cost of Medigap insurance. To find specific prices in your area for coverage specific to your needs, consult a Humana Medicare supplement plan representative.
You can enroll in a Medicare supplement plan during your initial enrollment period. This initial enrollment period runs from three months before to three months after your 65th birthday. There is also an annual open enrollment period in which you can enroll in a new or different Medigap plan. For further information on Humana Medigap plans, contact a Humana Medicare supplement plan representative. You can also read the full Humana Medigap review here.