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Humana Group Medicare PFFS
Flexible, affordable coverage
The Humana Group Medicare Private Fee-for-Service (PFFS) plan plan has no provider network – a feature that allows employers to cover retirees anywhere in the United States.
The plan combines all the benefits of Original Medicare and many extras into one simple, easy-to-use plan. |
A flexible choice
We can tailor PFFS plan benefits to fit specific circumstances, so we may be able to mirror your current plan designs. Members also have access to a variety of programs and services that promote healthy living and aging – at no additional cost. Extra benefits and services include fitness programs and Humana Active OutlookSM Humana's award-winning health and wellness program.
And since Humana is one of the largest and most experienced Medicare benefits providers in the country, you have the advantage of working with a company that understands what employers and consumers want in their Group Medicare benefits.
How the plan works
With the Humana Group Medicare PFFS plan, members enjoy several features and benefits:
- Primary care doctor’s office visits and annual routine physicals
- No copayment for preventive services, including cancer screenings and immunizations, for most plans
- Emergency coverage anywhere in the world
When you add a Humana prescription drug plan, members get drug coverage equal to or better than the minimum requirements for a Medicare Part D plan.
These plans are approved by the Centers for Medicare & Medicaid Services. However, it's important to understand what makes a PFFS plan different from other Medicare options:
- The plan pays benefits for healthcare providers who accept Medicare payment, Humana's terms and payment conditions each time the member seeks treatment
- Providers have the right to decide whether to accept Humana's terms and payment conditions each time the member seeks treatment
- The plan isn't accepted by all healthcare providers, even those who accept Medicare – members just need to ask providers if they accept the PFFS plan
Since it's crucial that anyone enrolling a PFFS plan understands these differences, Humana partners with our customers to educate retirees about the plan – during enrollment and throughout the year.
Advantages for employers
Chances are – because there are no network restrictions – you'll be able to offer all retirees a single PFFS plan regardless of where they live. However, the plan may not address all your coverage needs. If some of your retirees live in a specific geographic area with limited provider access, a PFFS plan may not provide an acceptable level of coverage. In these areas, you may want to consider offering an alternate plan such as another kind of MA plan or supplemental coverage. If faced with this situation, look no further than Humana; we offer a full spectrum of retiree medical solutions. You can depend on Humana for:
- Flexibility in choosing medical and prescription benefits, contribution amounts, and cost-sharing levels
- Dedicated account executive and implementation team
- Initial and annual enrollment meeting support
- Dedicated call center for members
- Fast and accurate claims payment
- Money-saving features such as our health resources and RightSourceRxSM, Humana's mail-order prescription drug service
MEMBER RESOURCES
Extra benefits and services for Medicare Advantage members
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Humana offers fitness programs to help Medicare members live healthy lifestyles. |
This life-enrichment program includes regular educational mailings, online content, seminars, discounts, and money-saving product offerings. |
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Group Medicare members with Humana prescription drug coverage have access to RightSourceRx - Humana's prescription home delivery service by mail. |
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