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Are Humana & Medicare The Same?

Many people wonder if Humana and Medicare are the same. Simply put, no. Medicare is a government administered health insurance program, and Humana is one of the largest private insurance companies. People get these two confused because Humana sells Medicare Advantage and Medicare Supplement Plans. Let’s go over what exactly the two are.

a picture of a balancer with green apples on onse side and oranges on the other.
When comparing Medicare and Humana, it can be like comparing apples and oranges. They are two different things.

Medicare

Medicare is the nation’s largest health insurance program for adults 65 and older. It is operated by the Centers for Medicare and Medicaid Services (CMS) under the US Department of Health and Human Services (HHS). Medicare is used by over 57 million Americans, and it is not based on income, and it is not free. In order to be eligible for Medicare, you must meet some requirements:

  • You must be 65 and older.
  • You must have worked and paid at least 40 qualifying quarters, or 10 years, of Medicare taxes to receive Medicare Part A.
  • You must be a U.S. citizen.

Medicare benefits are divided into two parts, Part A and Part B.

picture of different medical equipments
Medicare Part A and Part B covers a number of hospital and medical services. 
  • Medicare Part A (Hospital Insurance) — covers inpatient hospital care, skilled nursing facility care, short-term nursing home care, hospice care, and some home health care. (100% of your costs for up to 60 days in a hospital or up to 20 days in a skilled nursing facility.)
  • Medicare Part B (Medical Insurance) — covers annual wellness visits every month, ambulance services, orthotics and prosthetics, medical equipment, and mental health care. (80% of costs covered by Medicare.)

Medicare will cover 80% of your Part B expenses, leaving you with 20% to pay out of pocket. If the expenses get to be too much to budget, you can look into additional coverage to pay for the 20%, such as Medicare Supplement plans. These plans vary by premium, deductible, and coverage. Additionally, they are helpful to those who travel, as some cover international health care costs.

Humana

Humana is a private insurance company that sells Medicare Advantage plans, and Medicare Supplement plans for people looking for secondary insurance to help pay for Original Medicare. 

Humana is contracted with the federal government to provide these Medicare plans under the Medicare program. 

If you have Medicare and are interested in a Medicare Supplement plan, EZ.Insure can help! There are roughly 10 different types of medicare supplement plans on the market, and they all  vary in coverage and cost. Figuring out which plans are best for you can be hard, but we are here to help. If you would like to gather more information on Medicare and Medicare Supplement plans, one or our highly trained agents are ready to help.

You can start by simply entering your zip code in the bar above to get a quote, or you can contact us by email at [email protected] or call 855-220-1144. There is no hassle and no obligation. We will help you answer any questions, go over all of your plan options, find the Medicare Supplement plan most suited for your needs and budget, and even help you sign up if you’re ready.

Wait! Before You Drop Medicare For Employer’s Healthcare Coverage Read This!

It is more common for retired seniors to work. Almost 27% of people aged 65-74 are in the workforce, and the projected stats are rising. Some seek extra money, while others do it to pass the time. When you turn 65, you are enrolled in Medicare Parts A and B. If you decide to go back into the workforce, you can opt to drop Medicare Part B coverage and expenses. Coverage of the benefits you receive from Part B will be replaced with the employer’s group health insurance. You can always opt to go back to Medicare at any point, but there will be some repercussions if not done at the right time.

What Medicare Covers

Medicare coverage is divided into two parts, Part A and Part B. Medicare Part A covers hospital care, and is usually free as long as you meet the Medicare guidelines: working at least 10 years before age 65, and being a US citizen. Medicare Part B covers outpatient care, including annual wellness visits every month, ambulance services, orthotics and prosthetics, medical equipment, and mental health care. (80% of costs covered by Medicare.) The monthly premium for Part B is

Clock with coins in 3 rows next to it growing with a green leaf sprout on each row.
HSAs come with a triple tax benefit, but any contributions are tax-deductible.

$135.50 for 2019. The cost might be higher depending on income.. 

What Employers Offer: HSA Plans

Employer’s offer health insurance coverage, and usually a health savings account, HSA, as well. If you are on Medicare Part A, you cannot make any contributions to an HSA. The employer’s coverage is considered a “high-deductible” plan. HSAs come with a triple tax benefit, but any contributions are tax-deductible, and withdrawals are untaxed as long as it is used for qualified medical expenses. 

How It Will Cost You

If you drop your Part B plan for an employer’s plan, you can always sign up for Part B again during your Special Enrollment Period or SEP. This period is when you leave your employment, or the employment loses coverage. If you miss the 8-month SEP, you face a late-enrollment penalty, 10% of Part B’s monthly premium for each full year you should’ve been enrolled. 

If you drop Part A, you might have to repay the government for any medical services under Medicare that you used. Also, if you collect social security, you will need to repay that back also. 

Caucasian woman;s hand holding a pen ready to write on an openedbook with the page titled "my plan."
If you drop Medicare, returning can be difficult, so think carefully and explore your options completely before making a decision.

Some seniors buy a Medicare Supplement plan to support their Medicare Part B expenses. When you drop Part B and sign up for your employer’s coverage, then you will also have to drop your Supplement plan. If you decide to go back to Medicare Part B, buying a Medicare Supplement plan will not be as easy. Your coverage could be denied due to pre-existing conditions and health status.

If you plan to drop your Medicare and use your employer’s health insurance plan, it can cost you in the long run. Your decision should be based on how much your employer’s plan costs, your out-of-pocket expenses in a high-deductible plan, and your budget. If you drop Medicare, returning can be difficult, so think carefully and explore your options completely before making a decision.

Medicare Will Cover Glucose Monitors

Medicare is making some positive moves in the diabetes field. Not only are they now covering some continuous glucose monitors (CGMs), but they are also beginning to connect it to smartphones. Glucose monitors were not covered by Medicare last year. This left people with diabetes the only option of paying for it out of pocket. If they could not afford it, then they did not get one. These devices help diabetics manage their glucose levels. Now the readings can be transmitted to iPhones.

How A CGM Works

Medicare will begin to cover 2 brands of continuoius glucose monitors.
Medicare will begin to cover 2 brands of continuoius glucose monitors.

A sensor is worn on the arm or stomach area, and collects glucose data from under the skin. It will test glucose levels every few minutes and send the results to a monitor. The monitor will either be a part of an insulin pump, or a separate device you can carry. The monitor shows when a person’s glucose is going up, down, or staying steady. They are constantly working, even when the person is showering, working out, and sleeping. These devices will send an alert when the levels are high or too low. The sensors have to be replaced every 3 to 7 days depending on the model.

The Devices Now Covered By Medicare

The two CGM systems Medicare will now cover are Dexcom’s G5 Mobile and Abbott’s FreeStyle Libre. The two systems will be covered for beneficiaries with type 1 and type 2 diabetes. The Dexcom G5 Mobile monitors for up to a week and will send readings to an insulin pump or a wireless receiver such as a phone. This notifies the user when their levels are on the rise, falling, or steady.

The Freestyle Libre collects data up to 10 days from a sensor put into the arm. It will collect the data and the user will have to move a reader device over the sensor to check their levels. This device will show when a person’s glucose level is going up or down, but will not alert the user when it is out of range.

Smartphone Use

You can now connect your glucose monitor to your smartphone to keep track of levels.
You can now connect your glucose monitor to your smartphone to keep track of your levels, and share with your doctor.

Companies like Dexcom were able to develop these monitors the ability to transfer information to iPhones. Having levels sent to a smartphone will help users use the Share app. This app allows the user to share their glucose level information with their doctor and caregiver. However, one of Medicare’s conditions with the Dexcom Mobile device is that it is not covered if the person uses the smartphone app. Dexcom is trying to work things out with Medicare to get it covered.

Continuous glucose monitors were not covered by Medicare just a year ago. Now Medicare has loosened their restrictions, allowing two types of devices to be covered for beneficiaries. The only issue is within the limited conditions that it will not be covered if used with a smartphone. Medicare is currently under pressure by beneficiaries and these glucose monitor companies to come to some sort of agreement. Medicare is in talks with Dexcom. The company and users are hoping that the use of smartphones will be allowed, because it makes tracking levels and sharing them with doctors easier, which helps manage glucose levels.  

An Overview of the Different Medicare Supplement Plans

Medicare Supplement plans are purchased to help relieve some of the burden that Medicare part A & B leave behind in the form of out of pocket expenses. Medicare covers only 80 percent of Part B costs and the 20 percent is left for the individual to pay. Even though it is only 20 percent, it can be too much for a retired person to pay. Because of this, insurance companies decided to create Medicare supplemental insurance plans, to pay for that 20 percent difference to help with finances.

There are 10 different standard Medicare Supplement plans that are sold in most states. These 10 Medicare Supplement plans are A, B, C, D, F, G, K, L, M, N, as well as a high-deductible Plan F option. Not all plans cover the same services.

In general, all Medicare Supplement plans cover at least part of:

  • Medicare Part A and Part B deductibles
  • Skilled nursing facility costs (after you run out of Medicare-covered days)
  • Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used)
  • Medicare Part B coinsurance or copayment
  • Part B excess charges
  • Part A hospice care coinsurance or copayment
  • Blood (first 3 pints)

Two Medicare Supplement plans (Plan K and L) include an out-of-pocket limit. This means that once you have reached a certain amount spent on Medicare-covered services, the Medicare Supplement plan will cover 100% of Medicare-covered costs for the rest of the year.

An overview of the different Medicare Supplement plans and what they cover.
An overview of the different Medicare Supplement plans and what they cover.

* There is also a high-deductible version of Plan F.

Some Facts to Know:

  • All insurance companies that sell Medicare Supplement must offer Plan A. A company must also offer either Plan C or Plan F if it offers any other plan besides Plan A.
  • Each standard Medicare Supplement plan option must provide the same basic benefits. For example, a Plan A policy sold by a company in California will have the same basic benefits as a company in Pennsylvania selling the same lettered plan.
  • Plans E, H, I, and J are no longer offered, but if you already have one, you can keep using it until you decide to switch, then you cannot go back.
  • Not all Medicare Supplement plans may be available in your state. In Massachusetts, Minnesota, and Wisconsin, Medicare Supplement policies are standardized differently.
  • Standardized Medicare supplemental plans do not provide coverage for dental care, hearing aids, vision care, prescription drugs or long-term care.
  • You can see any doctor, whether they accept Medicare assignment or not. Medicare assignment is when your doctor or provider accepts the Medicare-approved amount as full payment.
    • If your doctor accepts assignment, then your Medicare Supplement insurance company will pay your doctor directly.
    • If your doctor does not accept Medicare assignment, you will have to pay your doctor yourself and send in claims to your insurance company.

Medicare SELECT

In some states you can purchase Medicare SELECT, which is a type of Medicare Supplement policy. Medicare SELECT can be any standardized Medicare Supplement plan (plans A-N). It requires the policyholder to use hospitals and doctors in their network. If it is an emergency, then you will not have to stay in network. Medicare SELECT plans often have lower premiums.

Medicare Part B bills can become overwhelming, so a Medicare Supplement plan is beneficial to sustain the costs. At EZ.Insure we are trained to be on your side and get you the best plan in your budget. Get an instant quote by typing your zip code in the bar above, or speak with someone now. You can contact one of our highly trained agents through email at [email protected], or by calling 855-220-1144. At EZ.Insure we want to help you get coverage, not help insurance companies get right. We know how hard it is dealing with a ton of phone calls and agents hounding you, which is why we want to help, we work for you. Let us help you today!

Medicare Coverage VS Medicare Supplement Coverage

Medicare is the federal health insurance program for people who are 65 or older. When you enroll in Medicare, it is important to understand how it works and whether or not you will need a Medicare Supplement plan to go with it. Once you pay your deductible, Medicare covers only 80% of your Part B expenses, leaving you to pay the rest. Medicare Supplement is an insurance plan that is sold by private companies. Medicare Supplement plans help pay for the 20% of the Medicare Part B costs which is left for you to pay.

Original Medicare, and Medicare Supplement plans cover different healthcare. It is important to go over each program, and what they offer in order to determine if a Medicare Supplement plan will benefit you.

How Medicare Works:

Every year, you must pay a set amount, a deductible, for your health care before Medicare pays its share. You can sign up for Part A and/or Part B insurance, but most people have both. You pay a monthly premium for Part B.  Medicare only covers 80 percent of Part B services, leaving you with the other 20 percent to be paid out of pocket. Depending on your medical needs in a given year, that 20 percent gap can become a large financial burden.

For 2017, the Medicare Part A deductible is $1,316 a year, while Medicare Part B’s yearly deductible is $183. Once you have paid your deductible in health bills such as physician visits, outpatient hospital services, and covered medical equipment, then Medicare will pay cover the rest up to 80% for Part B, and 100% for Part A.

Medicare covers wellness visits every month.
Medicare will cover annual wellness visits once a month.

What Medicare covers

Medicare benefits are divided into two parts, Part A and Part B.

  1.   Medicare Part A (Hospital Insurance) — covers inpatient hospital care, skilled nursing facility care, short-term nursing home care, hospice care, and some home health care. (100% of your costs for up to 60 days in a hospital or up to 20 days in a skilled nursing facility.)
  2.   Medicare Part B (Medical Insurance) — covers annual wellness visits every month, ambulance services, orthotics and prosthetics, medical equipment, and mental health care. (80% of costs covered by Medicare.)

What Medicare does not cover

  •         Annual physical exams except other than one annual wellness visit
  •         Health care you get while traveling outside of the United States (Very limited exceptions)
  •         Hearing aids, and most hearing exams
  •         Long-term nursing home care for more than 100 days
  •         Acupuncture, naturopathy, etc.
  •         Most eyeglasses
  •         Most dental care

Prescription drugs are not covered under Parts A and B, but it will cover some drugs in certain cases like immunosuppressive drugs for transplant patients, and oral anti-cancer drugs. For prescription drug coverage, you should consider signing up for stand-alone Medicare Part D plan.

How Medicare Supplement Works:

There is a monthly premium for your Medicare supplement plan, and in return, the plan pays most of your expenses not covered by Medicare parts A & B. For example, if you have a $4,000 ambulance bill and have already met the yearly Medicare Part B deductible, Medicare Part B will pay 80% of the bill. This leaves you to pay the 20% that us left, $800, out of pocket. But if you have a Medicare Supplement plan that covers Part B copayments and coinsurance costs, then it will pay the $800 remaining.

The Medicare Supplement Open Enrollment period is the six-month period that starts on first day of the month that you are 65 and enrolled in Medicare Part B. During the open enrollment period, you can enroll in any Medicare Supplement plan offered in your service area with guaranteed issue. This means that insurance companies are not allowed to deny you or charge you more due to pre-existing conditions. There are many different types of Medicare Supplement plans to choose from, and they vary in levels of coverage and cost.

What Medicare Supplement covers

Medicare Supplement covers nurse care and Part B excess charges.
Medicare Supplement will cover nursing facility costs after you run out of Medicare-covered days. 

In general, all Medicare Supplement plans cover at least part of:

  •         Medicare Part A and Part B deductibles
  •         Skilled nursing facility costs after you run out of Medicare-covered days
  •         Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used)
  •         Medicare Part B coinsurance or copayment
  •         Part B excess charges
  •         Part A hospice care coinsurance or copayment
  •         Blood (first 3 pints)

Some will cover:

  • Foreign travel emergency (up to plan limits)
  • Part B deductible

Two Medicare Supplement plans (Plan K and L) include an out-of-pocket limit. Once you have reached a certain amount spent on Medicare-covered services, the Medicare Supplement plan will cover 100% of the costs for the rest of the year.

What Medicare Supplement does not cover

Medicare Supplement policies generally do not cover:

  •         Long-term care (care in a nursing home)
  •         Routine vision or dental care
  •         Hearing aids
  •         Eyeglasses
  •         Private-duty nursing.
  •         Prescription drugs

Looking for more details or help?

There are roughly 10 different types of medicare supplement plans on the market, and they all  vary in coverage and cost. Figuring out which plans are best for you can be hard, but we are here to help. If you would like to gather more information on Medicare and Medicare Supplement plans, one or our highly trained agents are ready to help.

You can start by simply entering your zip code in the bar above to get a quote, or you can contact us by email at [email protected] or call 855-220-1144. There is no hassle and no obligation. We will help you answer any questions, go over all of your plan options, find the Medicare Supplement plan most suited for your needs and budget, and even help you sign up if you’re ready. No hassle necessary! We work on your time and do not hound you with calls like the other guys.

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