Humana Medicare insurance review

KFF’s 2026 Medicare Advantage enrollment analysis estimates that plans owned by Humana account for about 20% of nationwide Medicare Advantage enrollment, up from 17% in 2025. KFF also reports that Humana had the largest absolute enrollment increase among parent organizations, adding about 1.3 million Medicare Advantage enrollees from 2025 to 2026.

Humana’s July 29, 2026 SEC filing adds a newer company-specific snapshot: as of June 30, 2026, Humana reported 6.45 million individual Medicare Advantage members, 727,200 group Medicare Advantage members and 7.18 million total Medicare Advantage members. The filing also reported 3.95 million stand-alone Part D members and 551,500 Medicare Supplement members. These product counts are dated company membership measures and should not be treated as unique-person totals across products.

That market position is useful context, not a quality score. A large national enrollment base does not mean every Humana contract has the same benefits, network, premium or CMS Star Rating. The exact decision still has to be made at the county, ZIP-code and contract level.

2027 enrollment update (October 2026): Humana says its 2027 Medicare Advantage plans will be available in approximately 2,600 counties across 45 states and Washington, D.C. This is a separate 2027 service footprint, not the 2026 footprint discussed below. Before enrolling for 2027, confirm availability, providers and drug coverage for your ZIP code in Humana’s October 2026 announcement.

Humana’s official 2026 announcement says its Medicare Advantage plans are offered in 46 states and Washington, D.C., covering about 85% of U.S. counties. Current 2026 plan research identifies Alaska, North Dakota, South Dakota and Rhode Island as the four states without Humana individual Medicare Advantage availability. The map below therefore highlights the other 46 states plus Washington, D.C.

That footprint is still not a promise that a plan is available in every county. Medicare Advantage is service-area specific, and plan types can differ sharply by ZIP code. Humana also exited its individual Medicare Advantage business in Puerto Rico effective January 1, 2026, so older reviews that still describe a 48-state, Washington, D.C. and Puerto Rico footprint should not be used as current 2026 availability guidance.

Humana’s official Medicare pages list HMO, PPO, PFFS and Special Needs Plans. Current 2026 CMS-data analysis also separates HMO Point-of-Service plans, which combine an HMO structure with limited out-of-network access at different cost sharing. The exact plan types offered depend on the local market.

Network design matters as much as the plan label. HMO members generally rely on an in-network care structure; PPOs add broader provider flexibility but can expose members to higher annual out-of-pocket limits; PFFS members must confirm that a Medicare-approved provider accepts the plan’s terms. Special Needs Plans have additional eligibility requirements.

MoneyGeek’s September 2026 analysis of CMS Medicare Advantage landscape data estimates that 65% of Humana Medicare Advantage plans have a $0 monthly plan premium and that the average monthly premium across Humana plan types is $25. Its plan-type averages range from $2 per month for HMO-POS plans to $27 for PFFS plans.

A $0 plan premium does not mean Medicare coverage is free. Members generally still owe any applicable Medicare Part B premium, and plans can have copays, coinsurance, prescription costs and a medical maximum out-of-pocket limit. In MoneyGeek’s analysis, average in-network MOOP ranges from $4,856 for Humana HMO plans to $7,200 for PPO plans. These are national research averages, not personalized quotes.

2027 ratings update: Humana reported in October 2026 that 95% of its Medicare Advantage members were in plans rated four stars or higher for 2027. That overall figure does not establish the rating of a particular local plan. See Humana’s 2027 CMS Star Ratings announcement and check the specific contract before choosing coverage.

CMS assigns Star Ratings at the Medicare contract or plan level rather than giving every Humana plan one universal company score. MoneyGeek’s 2026 CMS-data analysis calculates a 3.66 out of 5 average across Humana Medicare Advantage plans, compared with a 3.81 national average in its dataset. By plan type, Humana PPO and PFFS averages are above the corresponding national averages in that analysis, while HMO and HMO-POS averages are below them.

Use those averages as research context only. The rating that matters for enrollment is the current CMS Star Rating attached to the exact contract available in your county. CMS publishes the official 2026 Star Ratings data and Medicare Plan Finder displays plan-specific quality information.

Humana says 100% of its 2026 Medicare Advantage plans include dental, vision and hearing coverage. Its 2026 announcement also says all non-SNP Medicare Advantage plans include $0 copays for covered preventive dental services and in-network preventive services, while nearly all include $0 in-network primary-care copays and $0 Tier 1 prescription copays, subject to plan-level exceptions and pharmacy rules.

Humana continues to offer three stand-alone Part D plans for 2026 and says approximately 83% of its PDPs have a premium decrease. The company also supports home-delivery pharmacy access through CenterWell Pharmacy. Drug formularies, preferred pharmacies, deductibles and tier-specific copays vary by plan, so prescription coverage should be checked using the exact formulary rather than a national summary.

Humana supports all three major Special Needs Plan categories: Dual Eligible Special Needs Plans for people who qualify for both Medicare and Medicaid, Chronic Condition Special Needs Plans for people with qualifying chronic conditions, and Institutional Special Needs Plans for people who meet institutional-level eligibility requirements. Humana’s 2026 materials say SNPs combine Medicare Parts A and B with Part D prescription coverage and add care coordination around the qualifying need.

For 2026, Humana specifically expanded D-SNP availability into Illinois and C-SNP availability into Idaho, Maine and New Jersey. Its official D-SNP information also highlights care-management support plus dental, vision and hearing benefits, while exact allowances, drug copays, Medicaid coordination and service areas remain plan-specific. Shoppers should verify both Medicare and Medicaid eligibility before treating a D-SNP as an available option.

Humana offers three stand-alone 2026 Medicare Part D plans: Humana Value Rx Plan, Humana Premier Rx Plan and Humana Basic Rx Plan. Humana says approximately 83% of its PDPs have a premium decrease for 2026, while the annual out-of-pocket cap for covered Part D prescriptions is $2,100. These plans are separate from Medicare Advantage and can be used by eligible beneficiaries who need stand-alone drug coverage with Original Medicare or compatible supplemental coverage.

The plan name alone is not enough to select a PDP. Compare the exact premium, deductible, formulary, drug tiers, preferred pharmacy network and mail-order terms for the ZIP code. Humana warns that access to lower-cost preferred pharmacies can be limited in some areas, so a national pharmacy-network statement should not be treated as a guarantee of preferred pricing locally.

Humana also sells Medicare Supplement insurance, which works alongside Original Medicare rather than replacing it. Humana’s official 2026 page lists standardized plans including A, B, C, F, G, K, L and N, subject to state availability and issuing-entity differences. Plans C and F have federal eligibility restrictions for people newly eligible for Medicare on or after January 1, 2020.

Medigap should be evaluated differently from Medicare Advantage. There is no Medicare Advantage-style medical network or plan MOOP structure to compare in the same way; instead, shoppers should compare standardized benefit letters, state-specific premium rules, underwriting or guaranteed-issue rights where applicable, and whether they also need a separate Part D plan.

Humana’s HMO, HMO-POS, PPO and PFFS designs can produce very different provider-access rules. HMO plans generally center care on the plan network and may use primary-care coordination; PPOs allow broader access but usually have different in-network and out-of-network cost sharing; PFFS members must confirm that a Medicare-approved provider accepts the plan’s terms. The exact Evidence of Coverage controls.

Before enrollment, search the provider directory using the exact plan and ZIP code, then verify hospitals, specialists and pharmacies directly when practical. Also review prior-authorization rules, referral requirements, out-of-network terms and the drug formulary rather than assuming that a doctor accepting one Humana Medicare plan accepts every Humana plan.

Humana also operates Medicaid coverage in selected states. Its current Medicaid enrollment page lists Florida, Indiana, Kentucky, Louisiana, Ohio, South Carolina and Virginia. Humana was awarded a statewide HealthChoice Illinois Medicaid contract in June 2026, and its Q2 2026 results say that contract is expected to go live in January 2027. These programs are state-specific and should not be treated as Medicare Advantage availability.

This Medicaid footprint matters most to Medicare shoppers when evaluating D-SNP and integrated dual-eligible coverage. Humana currently highlights integrated D-SNP programs in states including Illinois, Indiana, Michigan, South Carolina and Virginia, but exact eligibility, county coverage and Medicaid coordination rules are local.

Forbes Advisor’s September 2026 Medicare Advantage provider roundup gives Humana a 5.0 out of 5 third-party editorial score and names it Best Nationwide Coverage. That is an editorial rating, not a CMS Star Rating, customer-review score or ApexTrusted score.

MoneyGeek gives Humana a 4.4 out of 5 editorial score in its current 2026 review and publishes the CMS-derived cost and quality averages used in the plan-metrics tables below. AM Best affirmed an A (Excellent) Financial Strength Rating for Humana Health Group on December 16, 2025. That rating applies to the health and dental insurance subsidiaries collectively identified by AM Best as Humana Health Group, not automatically to every Humana-branded legal entity.

Use your ZIP code in Medicare Plan Finder and Humana’s plan search, then compare the exact Summary of Benefits, Evidence of Coverage, provider directory and formulary. Check the monthly premium, Part B obligations, maximum out-of-pocket limit, hospital and specialist network, drug tiers, preferred pharmacies, prior authorization, referral rules, out-of-network coverage and any Part B giveback or supplemental allowance.

For Humana in particular, avoid relying on older national availability figures. The 2026 footprint is narrower than the older Forbes review, and CMS Star Ratings vary by contract. The most useful decision is therefore local and plan-specific, even though national averages can help narrow the field.