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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's process is the same as it has been in the past regarding Medicare enrollment. 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.

If your MBI and Part B entitlement are on record with MSU and your are enrolled in an existing MSU health plan, you will automatically be enrolled in the Humana Group Medicare Advantage PPO plan, and Humana will enroll you in Medicare Part D with the Center for Medicare and Medicaid Services (CMS). In this case, no action is needed on your part with CMS.

 

It stands for Medicare Beneficiary Identifier. In 2018, CMS started a project to replace the Social Security Number on the Medicare Health Insurance card. It also replaced the Health Insurance Claim Number (HICN) that providers used to process claims. On your Medicare card it is the 11-digit identifier under the title “Medicare Number.”

Medicare card

 As a Medicare eligible individual, enrolled in the MSU CVS/Caremark Prescription Drug Program, you will not be assessed a late enrollment penalty because you currently have other creditable prescription drug coverage through MSU. It is true that there is a late enrollment penalty if a person does not have other prescription drug coverage when first Medicare eligible, and the person does not enroll in Medicare Part D.

Yes, Humana has a broad, national provider network that is comparable to the networks currently in place for retirees.

In September, there will be a Humana Call Center for MSU that you may contact; the number will be coming soon. At the same time you will be able to check online. We will share the Humana website when it is complete.

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 MSU Customer Service for assistance with anything related to the Humana plan; the number will be added to these FAQs in September when the plan has been approved by the Center for Medicare and Medicaid Services (CMS).
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.
Yes, similar to the Blue Cross Blue Shield of Michigan (BCBSM) plans in place today, 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 do not need to enroll in the Humana plan if you are already enrolled in an MSU health/prescription plan, you will be automatically enrolled in the Humana plan. This includes both the health benefits and prescription drug coverage. If you are not currently enrolled in an MSU health care/prescription plan, you will have the opportunity to enroll during this October’s Open Enrollment.
Yes, you will receive information from Humana about the plans and in the packet, there is an opt out form that you may complete if you do NOT want this health care and prescription drug coverage. You may also opt-out online via EBS during Open Enrollment in October.
No, as of December 31, 2020, BCBSM will no longer be an option for individuals eligible for the Humana health care plans.
In late November/early December, Humana will be sending you a confirmation of enrollment letter and an insurance card. 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.

The Humana plan details are drafted and going through a rigorous approval process that includes MSU, Humana Corporate and for the Humana Group Medicare Advantage PPO, the Centers for Medicare & Medicaid Services (CMS). The review is necessary for CMS compliance and Humana operational processes and policies. Upon completion of the review, MSU will provide a summary of benefits comparison so you may see how the new plan looks compared to the old plan. This information will be shared in September.

 

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; we will update this with the number in September.

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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