Humana -- Start Posting 2008 Changes

[honestagent]

Do you think that will be the case with the new Chesapeke MA? No one will accept it?

Not necessarily; but can you imagine a billing specialist looking at yet another card she's never seen nor heard of called, "Chesapeake." She may say... 'what's this?' And toss it unless you're proactive with her; I had to do a lot of that for my clients with Wellcare last year.

Why risk that to your client unless you will be proactive and call in advance to ensure they do or teach them and see if they will. I don't know about you,but I don't plan to call up any more doctors' offices if I don't have to - to educate them. I am not a provider specialist but can play that role too if I absolutely must; the companies I plan to go out on have done a good job already in selected areas so I'm going out on the bigger house hold names that's a best fit for each person.

 

[scottfree]

You can now download the Humana SOB's for your area at

Medicare Benefits: Find affordable Medicare plans at Humana Medicare

 

[Cenla Agent]

Do you think that will be the case with the new Chesapeke MA? No one will accept it?

Who knows. I do know they are associated with MEGA.

 

[Cenla Agent]

That is why I am sticking with the larger companies that are been in my area for this last year. Pyramid, Wellcare and Unicare. All 3 have better plans than Humana. Wellcare and Pyramid are the top 2.



I am contracted with them but not sure if I am going to use it. They are in just a few counties nationwide. Who know if they will be around next year or if they are just tring to get members so they can sell their book to another company.

I see they are only in about 12-15 parishes out of 66 in Louisiana.

 

[Cenla Agent]

Scott,
Thank you for the welcome. Yes I agree with you 100 percent that Humana falls in last place. I plan to do the same with my Humana clients. It sounds like their plans are very similar in our states. The 0 plan here is 650 hospital stay and the 20 is 200 per day. They also have a huge share of the market in my area.
Carolyn

Gold Choice is much closer to $100 (if not over) per month in many states, especially those with HMO markets.

 

[Cenla Agent]

Scott, thanks for posting the link. As someone said earlier, Humana is indeed a "monster" this year, at least in the parts I've sold in Louisiana in the past. PFFS went from $89 to $109 to $19 and $39, the HMO footprint is expanded, and the PPO is much cheaper as well. Some other plans may possibly be better, but these plans are very competitive and with their name recognition in the state as well as their marketing efforts they are still very much a force to be reckoned with.

I notice they have changed the SNF copay to where it pays the first 20 days as well, just like Medicare does.

 

[insurance0707]

Has anyone taken a close look at the Humana PPO, in my state they are offered in every county for $37 a month with rx coverage. Has anyone researched or looked into this plan?

 

[Cenla Agent]

Has anyone taken a close look at the Humana PPO, in my state they are offered in every county for $37 a month with rx coverage. Has anyone researched or looked into this plan?

I think the MOOP went down with this plan too, although since it is a Regional PPO the plan benefits probably vary according to region, unlike Gold Choice which is the same everywhere other than the premium. This plan went down in LA and MS from $89 to $59 this year, which will make it more attractive. But in some areas Gold Choice (PFFS) went down to $19 for Plan A and $39 for Plan B.

The biggest thing to be concerned about is making sure the member understands the difference between in and out of network. If it is someone who has recently retired and had a PPO before, it usually is no problem. But if it is someone who has never had a PPO before, it could be more of a problem. Sure their PCP may be in the network, but is the provider they are being referred to in network? Some doctors will be more mindful than others in referring their patients to in network providers.

Another issue with Humana is that there are dozens of Humana plans out there, from group, the different Medicare plans, etc. Often a member will call a provider asking "Do you take Humana?" and not ask about the specific plan. Most providers will take some kind of Humana plan, but what needs to be asked is whether they specifically take "Choice PPO".

 

[insurance0707]

Thanks for the reply Cenla.....I tried to find the list of PPO doctors and hospitals on their website but to no avail. It sounds like the network is nationwide, not just regional. Do you have a link for the doctors/hospitals?

Also, are the captive agents the only one's that can take an application online? Do you know the process for 2008 on enrollment choices i.e. face to face, paper apps, electronic apps, etc.

 

[Cenla Agent]

Thanks for the reply Cenla.....I tried to find the list of PPO doctors and hospitals on their website but to no avail. It sounds like the network is nationwide, not just regional. Do you have a link for the doctors/hospitals?

Also, are the captive agents the only one's that can take an application online? Do you know the process for 2008 on enrollment choices i.e. face to face, paper apps, electronic apps, etc.

It is not nationwide but will be statewide or cover more than one state if your regional PPO encompasses more than one. Don't have the time to hunt down the exact link (maybe later), but look on their site (humana.com, not humana-medicare) where it says "find a physician" etc. Click on your state and it is under "Choice PPO". Usually the directories are broken up into regions of a state, etc., or you can dl a huge file that includes everything.