Humana experiences anyone?

Jul 11, 2007

  1. Marc
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    Marc New Member

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    What kind of experiences have you guys had with Humana? Service, rate increases underwriting etc. They are relatively new here and just got the network to where i feel comfortable with them.
     
    Marc, Jul 11, 2007
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  2. Sam
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    Sam Founder Administrator

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    Individual, group, or senior insurance?
     
    Sam, Jul 11, 2007
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  3. CHUMPS FROM OXFORD
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    CHUMPS FROM OXFORD Guru

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    Rates are decent (max 4 office visits). In the ballpark, but not the lowest. Maternity rates are good, although the coverage is just a hare better than Golden Rule.



    [​IMG]
     
  4. The New Guy
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    The New Guy Guru

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    Rabbit looks familiar, Monty Python I think. Does he do any appearances? I'm looking for a seminar speaker.
     
  5. BKrocko
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    In CO, Humana is one of only 4 carriers (GR, Time & State program) to offer maternity coverage. The part that I do not like is after a 1K maternity deductible, the client is responsible for 40% of the bill. If there are complications, and the bill go to eg: 100K, the client gets to pay out 40K. That sucks but it is better than owing 100K.

    Although Assurant is more expensive, in a case like that - the client would only be responsible for the maternity deductible, anything over the deductible is covered. The State program is also expensive but covers anything over the deductible as well - but it only pays the agent a one time commish of $25. (Use this program if the client is already pregnant).
     
    BKrocko, Jul 11, 2007
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  6. CHUMPS FROM OXFORD
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    CHUMPS FROM OXFORD Guru

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    Yes...he does look like the attack hare on MP.

    [​IMG]
     
  7. Marc
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    Marc New Member

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    Thanks for the feedback. Right now i am just doing individual health with them but am looking to move into the senior market as well. how are they about paying claims, netowork discounts, rate increases, provider feedback etc. As far as the maternity issue - they dont have maternity available on their HSA plans here. And, if there were complications - wouldn't that be covered by the major medical plans? I know there are some differences in what you and i would consider to be complications and the insurance company.
     
    Marc, Jul 12, 2007
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  8. BKrocko
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    In CO, C-sections are covered by state mandate. Coverage for complications is VERY limited and varies by state. Also, it does not include complications for the baby - as in NICU etc. I would not count on it for much.

    Humana is a well respected company but I am sure they have their share of complaints as well - just like any other carrier. I don't know anything about the senior market, it's not an area I work. I just got appointed with Humana individual products this year and have no information on how their rate increases are - again, this will vary by state/region.
     
    BKrocko, Jul 12, 2007
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  9. Cenla Agent
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    Cenla Agent Guru

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    With regard to individual plans, I believe Humana is relatively new to that market so I don't know if there is enough of a track record to be able to judge rate increases, etc.

    I really can't comment on group since I have not entered that market.

    For Medicare Advantage (HMO, PPO, PFFS), the rates and plans are going to vary by state and service area. For example, in one state, one metro may have a $0 premium HMO that has awesome benefits and another metro may have one that has substantially higher copays. One part of the state may have a PFFS that is very low and another may have the same plan for over $100 per month. Humana focuses more on the managed care plans, although they do have PFFS as well and PFFS is all they have in some states. Most of their major competitors with the exception of United are only offering PFFS. Even in areas where their PFFS is way more than some other companies, some people will enroll anyway because Humana is a far better recognized name than some of the newcomers to this market. Their PFFS is MAPD only whereas most competitors offer plans that are MA only. Humana is also getting into Group MA, where they can set up a Group PFFS (I think it is) plan for companies that have IIRC 10 or more Medicare Beneficiaries in their group plans. They recently did that with the state employees here.

    WRT providers (other than independent pharmacists) I think the response is generally positive although of course you will have some that loathe them as you do with no doubt every company.
     
    Last edited: Jul 12, 2007
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