Understanding your healthcare coverage is crucial, especially when navigating the options available through Medicare and private insurers like Humana. If you’ve ever wondered “can you have Medicare and Humana at the same time?”, the answer is yes—with some important considerations.
How Do Medicare and Humana Work Together?
Medicare is a federal health insurance program for people aged 65 and older, or those with certain disabilities. It consists of several parts:
- Part A (Hospital Insurance)
- Part B (Medical Insurance)
- Part C (Medicare Advantage Plans)
- Part D (Prescription Drug Coverage)
Humana is a private insurance company that offers Medicare Advantage (Part C) and standalone Part D prescription drug plans. When you enroll in a Humana Medicare Advantage plan, you’re still in the Medicare program, but Humana manages your benefits instead of the federal government.
Example:
If you have Original Medicare (Parts A and B), you can also enroll in a Humana Part D prescription plan. Or, you can choose a Humana Medicare Advantage plan, which combines hospital, medical, and often drug coverage under one plan.
When You Have Medicare and Humana, Which One Is Primary?
When you enroll in a Humana Medicare Advantage Plan, Humana becomes your primary insurer. This means your healthcare providers will bill Humana instead of Original Medicare. However, you are still considered a Medicare beneficiary and entitled to all the rights and protections under Medicare.
If you have Original Medicare and a Humana Medigap (Supplement) plan, then Medicare pays first, and Humana pays secondary to cover remaining out-of-pocket costs.
Can a Patient Have Both Traditional Medicare and a Humana Medicare Advantage Plan?
No, you cannot have both Original Medicare and a Medicare Advantage Plan at the same time. You must choose one or the other. If you enroll in a Humana Medicare Advantage Plan, your coverage through Original Medicare is replaced and managed by Humana.
However, you can still switch back to Original Medicare during the Annual Enrollment Period (AEP) from October 15 to December 7 each year.
What Is the Downside of Humana?
While Humana offers competitive Medicare Advantage plans, there are potential downsides to consider:
- Network limitations: You may be restricted to in-network doctors and hospitals.
- Prior authorizations: Certain treatments or medications may require pre-approval.
- Out-of-pocket costs: Copays and coinsurance can vary and may be higher for some services.
- Plan changes: Benefits and provider networks can change annually.
Always compare the benefits, premiums, and provider networks before choosing a plan to ensure it fits your healthcare needs.
Final Thoughts
So, can you have Medicare and Humana at the same time? Yes—but it depends on the type of Humana plan. You can have Original Medicare and a Humana Part D or Supplement Plan, or you can choose a Humana Medicare Advantage Plan that replaces Original Medicare.
Always review your options carefully and consult a licensed insurance agent if needed.
