MSU Human Resources >> Benefits >> Healthcare >> Humana Health Care Plans with Prescription Drug Coverage Frequently Asked Questions


Humana Frequently Asked Questions

The following are frequently asked questions regarding the Humana health care with prescription drug coverage plans.

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Humana has a long history in providing Commercial and Medicare Advantage health plans. They offered their first private Medicare Advantage plans in 1985. Humana Medicare Advantage plans include a full spectrum of integrated, senior-focused care management programs designed specifically to meet seniors' needs. They also have a comprehensive suite of health management programs designed to address the entire continuum of health needs for MSU's retiree population.

There will not be an MSU premium associated with the Humana plans for retirees with full university contribution hired on or before July 1, 2002. For retirees that are not fully vested, the premium associated will be based on the vesting contribution level consistent with current practice.

There is no longer a higher cost plan, Retirees have one option for health care moving forward, you will either be on the Medicare or the non-Medicare plan.

Note: For retirees enrolled in the Humana Group Medicare Advantage PPO, as the process exists currently, Medicare will continue to charge you a Medicare Part B premium. Existing Part B costs, including Late Enrollment Penalty (LEP) or Income Related Monthly Adjustment Amount (IRMAA) fees will apply consistently with current practice. 

In addition, since the Humana plan includes Medicare Part D prescription drug coverage, for most people a Medicare Part D cost does not apply. However, as with Part B, Medicare Part D Late Enrollment Penalty (LEP) or Income Related Monthly Adjustment Amount (IRMAA) fee may apply. For more information on costs for Medicare Parts B and D, please see the links below:

https://www.medicare.gov/your-medicare-costs/part-b-costs

https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/monthly-premium-for-drug-plans

Offering retiree health care and prescription drug coverage through Humana combines Medicare A, B and D together in one convenient plan. Humana will process all claims, which minimizes coordination of benefits with the Center for Medicare and Medicaid Services (CMS).
The new prescription drug plan allows MSU and retirees to take advantage of better pricing and governmental assistance programs while providing a high-quality, affordable pharmacy benefit to retirees at the same time.
MSU requires Medicare eligible individuals to enroll in Medicare when eligible and sign up for Part B. Once you receive a card, you will need to provide the Medicare Beneficiary Identifier (MBI) to MSU. The following FAQ provides and explanation of what that number is used for by Medicare and where you will find it on the card.

When searching for a provider, you may call the Humana Customer Care team for assistance at 1-800-273-2509, Monday through Friday, 8 am to 8 pm Eastern time. If you prefer self-service, you may also search online using the Physician Finder tool. With this tool, you will find nearby doctors, hospitals, pharmacies, and other healthcare providers in the Humana network. You can get phone numbers, addresses and maps, customize your search by specialty and see the distance from your home or work. 

There are several ways to access the Physician Finder tool. You can visit Humana.com/PhysicianFinder, or visit the “Tools & Resources” page from your Humana MSU landing page:

Medicare Advantage PPO: https://our.humana.com/msu/

Non-Medicare PPO: https://our.humana.com/msu-commercial/

Once you access the tool, you will select the “Medical” tab.

Medicare searches:

  • Input the desired zip code
  • Look up by Coverage type “Medicare or Medicare-Medicaid”
  • Select the 2021 coverage year
  • Choose the “Medicare PPO 2021” network

 Non-Medicare searches:

  • Input the desired zip code
  • Look up by Coverage type “Insurance through your employer”
  • Select the “Humana/ChoiceCare Network PPO” network

 After inputting search criteria, you can search providers by name, specialty, or condition.

This plan is a Passive PPO, which means your benefit levels are the same for in-network and out-of-network providers. Individuals on this plan can use any provider in the country who accepts Medicare and agrees to bill Humana.
Yes, members may call Humana Customer Care at 1-800-273-2509 (TTY: 711).
Although most health care providers will submit claims to Humana, members can file claims directly. You can download a claim form from the Humana website at www.humana.com.
The MSU plan is a PPO plan and members in the non-Medicare plan receive a higher level of benefits if being treated by a network provider.
First, it is important that you notify MSU and Humana as soon as possible with address changes. If you reside in a state that is outside of the Humana/ChoiceCare network service area, and give notification of your change in state residence, covered members will be placed in an indemnity plan and have the same benefit level whether seeking services in-network or out-of-network.
You will receive an enrollment kit from Humana to review health and prescription drug benefits and coverage to decide if you want to continue your healthcare and prescription drug coverage with MSU. You will receive this information if you are retiring or have a change in Medicare eligibility.  MSU will also send you information and an enrollment form that you must complete to keep your healthcare and prescription drug coverage. Please note, If you do not take action within 30 days of your new benefits eligibility date, your coverage will be terminated and you will not be able to enroll again until you have a qualified life event or the next MSU open enrollment.
Upon completion of your enrollment at MSU, Humana will send a new Medical insurance card. MSU recommends enrolling as soon as possible in the new plans and when possible, within 45 days of your change in status at MSU for the best experience. You will receive one card that may be used for both medical services and prescription drugs. This one card is all that is needed for services, you no longer need to show your Medicare card at appointments; however, we suggest you keep the card and put that in a safe place at home.
 

CMS is a federal agency in the US Department of Health and Human Services (HHS) and they administer the Medicare program and work in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards. The new Humana Group Medicare Advantage PPO plan is a Medicare Advantage and Prescription Drug (MAPD) plan, and CMS requires that all MAPD plan designs and informational materials go through an approval process with CMS before they may be released to the public. The process is in place to protect consumers from fraud and abuse in the health care marketplace.

A member may call Humana MSU Customer Service for assistance with anything related to the Humana plan at 1-800-273-2509 (TTY: 711). 

While the Humana plans combine health and prescription coverage, dental coverage is not impacted and will continue to be offered through Aetna and Delta Dental consistent with current practice.

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