How is individual health insurance different from insurance through an employer?

Insurance you get through an employer is called “group” health insurance, meaning the rates are determined based on everyone in the group. In contrast, individual and family health insurance rates are based on the people covered and their past medical history much like your car insurance rates are based on the people covered and their past driving history.

HumanaOne quotes take into consideration where you live, your age, your gender, and if you use tobacco products. Once you apply, we’ll let you know if your medical history has an impact on your rates and/or eligibility.

How do I decide whether to get a HumanaOne HSA-qualified High Deductible Health Plan or a HumanaOne  Individual Health Plan?

A lot of factors go into that decision, including eligibility, healthcare spending, and your personal preferences. We encourage you to check out the HumanaOne HSA -qualified High Deductible Health Plan section of our web site. Review the Benefit Sheet for each plan to find your potential out-of-pocket costs, and then get a quote for both types of plans. Add your out-of-pocket costs and monthly insurance rates to find which plan is a better choice for you.

How do you decide the cost of my health insurance plan?

The cost of your health insurance plan is determined by your medical history, age, gender, location, benefits selected, smoking status, and effective date. Unless you change your plan or relocate, your rate is guaranteed to remain the same for the first twelve months of your plan.

What’s a copayment?

The amount you pay to a provider toward covered expenses of certain benefits.

What’s a deductible?

The amount that a covered person must pay in a calendar year and is responsible to pay before we pay certain benefits.

How does a PPO plan work?

A PPO(Preferred Provider Organization) plan is offered by insurers who have a network of healthcare providers contracted to provide services at a discounted rate. A PPO plan offers you the freedom to continue using your family doctor or any other doctor you prefer. However, if the doctor or hospital you choose is not on the list of the insurer’s in-network providers, the plan generally covers a smaller portion of the total costs.

How do I find out if my doctor is in Humana’s network?

Use Physician Finder to look for doctors, hospitals, and other providers in Humana’s network.

How do I find out if the plan covers a particular prescription drug?

After you reach a separate $500 deductible, our prescription drug plan offers four levels of benefits, called Rx4. This means you pay different copayment amounts based on the type of medication. You can use our Prescription Tools and Resources page to see what you’d pay for a particular prescription drug. Just select “Rx4” from the drop-down menu and then search using any of the methods shown.

How does the zero deductible Rx benefit option work?

When you choose the optional zero deductible Rx benefit, you pay an additional premium, but you don’t have to meet a separate $500 RX deductible before pharmacy benefits begin.

How does the office visit copayment benefit option work?

When you choose the office visit copayment benefit option, your plan pays office visit benefits at 100 percent after a copayment. This benefit applies only when you see an in-network primary care doctor or specialist for a covered illness or injury. It doesn’t apply for preventive care services or services from out-of-network providers. The office visit copayment benefit option is limited to four visits per year per member. (In Arizona and Utah the copayment benefit is included automatically in the medical coverage with no visit limit.)