There’s no doubt about it, Humana has been the 800 LB gorilla in the Medicare Advantage market. They have had some attractive offerings since Medicare Advantage plans first became available.
Humana Gold Choice is a very popular plan for Medicare beneficiaries who don’t want network restrictions.
Gold Choice is a private fee-for-service (PFFS) Medicare Advantage plan. A PFFS plan allows members to choose any provider that accepts Medicare assignment. But merely choosing a provider doesn’t necessarily mean that the provider will accept your plan. A provider must accept the plan’s payment terms and conditions. Providers also have the option to accept a PFFS plan on a visit-by-visit basis.
Humana Gold Choice premiums
PFFS Advantage plans have become known as the plans with the highest monthly premiums. Insurance companies that offer PFFS plans don’t have the luxury of lower provider costs . Insurance companies are able to negotiate rates with providers in return for the providers having access to the companies members.
What would you do if you where Humana?
- Keep the premium the same and earn less profit?
- Raise the premium and keep the same level of benefits?
- Keep the premium at the current levels and reduce benefits?
Another possible scenario would be for Humana to not renew the plan and migrate its members to their Human Choice plan. Humana Choice is a PPO with a strong provider network.
Many providers have pulled out of the PFFS market due to legislation that became effective in 2011. Companies that offer PFFS plans also have make available a provider network to the PFFS plan members.
Should you be worried?
If you have Humana Gold Choice, you have nothing to worry about this year. Even if a company decides to non-renew your Advantage plan you will still maintain all of the plan’s benefits through the end of the year.
If you have Humana Gold Choice it would be wise to explore your options during the Annual Enrollment Period. Humana is a good company but you may be able to save some money by shopping. Take a look at the Humana Choice as well as other plans available in your area.