Humana Medicare Advantage 2026 Review: Real Costs and Coverage Breakdown
Key Takeaways
Here are the essential insights about Humana Medicare Advantage plans for 2026 that will help you make an informed healthcare decision:
• 66% of Humana plans offer $0 monthly premiums with standard dental, vision, and hearing coverage included, making them highly affordable compared to competitors.
• Quality ratings lag behind competitors at 3.61 stars versus 4.02 industry average, with only 20% of members in 4-star-plus plans compared to 78% at UnitedHealthcare.
• True costs extend beyond premiums – factor in specialist copays ($30-$50), prescription drug tiers, and maximum out-of-pocket limits averaging $5,951 annually.
• HMO plans require network restrictions for lower costs, while PPO plans offer provider freedom at higher premiums – choose based on your healthcare priorities.
• Part B premium givebacks can reduce your standard $202.90 monthly Medicare Part B cost, with Humana offering more giveback plans than any major carrier.
Despite below-average quality ratings, Humana’s combination of affordability and comprehensive benefits makes it worth considering if upfront costs matter more than premium service ratings. The company’s significant enrollment growth suggests that many Medicare beneficiaries value this trade-off.
Choosing the right Humana Medicare Advantage plan can feel overwhelming. So many options exist, and costs vary in different regions.
Humana Medicare Advantage plans offer a $0 premium for 66% of their options. Coverage is available in 48 states. You should understand what you’re getting for your money. But not all plans are created equal, especially in terms of quality ratings and out-of-pocket costs.
Everything you need to know about Humana Medicare Advantage plans in 2026 is broken down here. This includes real cost examples, coverage details, and plan types. We provide an honest breakdown of the pros and cons to help you make an informed decision.
Humana Medicare Advantage Plans Overview
Humana operates as a Medicare Advantage HMO, PPO, and PFFS organization with contracts to serve both Medicare and Medicaid populations [1]. The company has served Medicare beneficiaries for decades. As of June 2025, it had more than 8.2 million total Medicare members, with about 5.8 million enrolled in Medicare Advantage plans [1].
What Makes Humana Different From Other Providers
Humana’s 2026 plans stand out for their benefit consistency. All non-special-needs Medicare Advantage plans include dental, vision, and hearing coverage as standard benefits [1]. This 100% inclusion rate sets Humana apart from competitors who often charge extra for these services [2].
Nearly all Humana Medicare Advantage plans offer $0 copays for in-network primary care provider visits and for Tier 1 prescriptions [1][2]. The company managed to keep a focus on standardized plan offerings with easy-to-understand materials. These materials were designed after the company collected feedback from thousands of Medicare members [1]. More than 80% of Humana Medicare Advantage members will be in plans with stable benefits for 2026 [2].
The company also emphasizes preventive care at no additional cost. All plans have $0 copays for in-network preventive services, preventive dental services, preventive and diagnostic mammograms, colonoscopies, bone density exams, and prostate exams [3][1]. Humana has care management support for Dual-eligible Special Needs Plans to manage complex chronic conditions. Most DSNPs feature a Healthy Options Allowance to help pay for covered over-the-counter items [1][1].
Service Area: Where Humana Plans Are Available
Humana Medicare Advantage plans are available in 46 states and Washington, D.C., covering 85% of U.S. counties [1]. The company is expanding into new territories for 2026. New plan types will become available in four states and 177 counties [1].
The insurer is also broadening its footprint in Special Needs Plans. Humana introduced benefits to support members with End-Stage Renal Disease or Chronic Kidney Condition on certain non-special needs Medicare Advantage plans in Oklahoma, Texas, North Carolina, and Virginia for 2026 [1].
Humana’s pharmacy network has limited lower-cost, preferred pharmacies in urban and rural areas in most states [1]. The network structure varies by location, with very few preferred cost-share pharmacies in certain states such as Connecticut, Delaware, and Massachusetts [1].
Enrollment Numbers And Market Position
Humana added roughly 1 million individual Medicare Advantage members during the 2026 sign-up period [4]. The company expects to grow its Medicare Advantage membership by more than 25% this year. This could lead to an enrollment of almost 7.3 million members by the end of 2026 [4].
This growth trajectory positions Humana to potentially supplant UnitedHealthcare as the largest Medicare Advantage carrier in the United States [4]. Most major MA insurers tried to cut benefits and exit markets to improve margins. Humana managed to maintain generous benefits in its remaining plans, making it an outlier among major carriers [4].
Only Humana and Kaiser Foundation Health Plan saw enrollment increases among the five largest Medicare Advantage insurers. Humana boosted enrollment by 1.2 million enrollees [4]. UnitedHealth Group lost over 530,000 enrollees compared to February 2025 [4].
Quality ratings remain a concern despite this enrollment success. Humana Medicare Advantage plans received an average rating of 3.79 stars out of 5 from the Centers for Medicare & Medicaid Services for 2026, below the industry average of 4.02 [5]. About 37% of Humana Medicare Advantage members are in plans rated 4 stars or better for the 2026 plan year [5].
How Much Does Humana Medicare Advantage Really Cost In 2026
The true cost of Humana Medicare Advantage plans goes beyond the advertised premium. Many plans promote $0 monthly premiums, but your total healthcare expenses depend on copays, deductibles, and prescription drug tiers.
Average Monthly Premiums Across Plans
About 66% of Humana Medicare Advantage plans carry a $0 premium [4]. Plans that charge a monthly fee average $26.88 per month weighted by enrollment [4]. These figures only tell part of the story.
You must continue paying your Medicare Part B premium, regardless of the plan you select. The standard Part B premium in 2026 is $202.90 per month [6]. Some Humana plans offer a Part B premium reduction, sometimes called a “giveback,” which can reduce your monthly Part B cost by up to $1.00 but no more than the original Medicare Part B premium amount [7].
Real costs vary substantially by location and plan type. Portland, Oregon’s Humana Gold Plus H1036-153 HMO plan charges $0 monthly premium [8]. Brooklyn, New York’s Humana Gold Plus H3533-035 HMO plan costs $22 per month [8]. The Flagstaff, Arizona, regional PPO plan costs $37 per month [8].
Doctor Visit Copays: Primary Care And Specialists
Primary care visits at in-network providers have a $0 copay across most Humana Medicare Advantage plans [3][7]. This applies to office visits and telehealth appointments [7]. The company promotes unlimited visits to in-network primary care providers with $0 copays on many plans [3].
Specialist copays range between $30 and $50, depending on your plan and location [8]. The Tulsa, Oklahoma HMO plan charges $30 for specialist visits [8]. The Daytona Beach, Florida, PPO plan sets specialist copays at $45 [8]. Telehealth specialist visits cost $40 on some plans, though out-of-network telehealth may not be covered [7].
Prescription Drug Costs At Different Tiers
About 90% of Humana plans include prescription drug coverage [4]. Tier 1 (preferred generics) offers $0 copays on 99.2% of plans [4]. A drug with a $15 retail price costs just $3.38 out of pocket on average among plans with copays at this tier [4].
Tier 2 generics are in 38.2% of plans with $0 copays, and the average out-of-pocket cost for a $50 retail drug is $5.68 [4]. Tier 3 preferred brands become more expensive. Only 1.2% of plans offer $0 copays, and the average cost is $44.34 for a $200 retail medication [4].
The Part D deductible maxes out at $615 in 2026 [7], though some plans split this between tiers. One plan charges a $0 deductible for Tiers 1 and 2 but requires a $350 deductible for Tiers 3, 4, and 5 [7]. Another charges $601 for the higher tiers [9]. Insulin costs are capped at $35 for a one-month supply [7][9].
Annual Deductibles And Maximum Out-Of-Pocket Limits
Medical deductibles vary. Many Humana plans have $0 medical deductibles [8][7]. Others charge $500 [8][6]. The average maximum out-of-pocket spending cap across Humana Medicare Advantage plans is $5,951 weighted by enrollment [4].
Specific MOOP limits range from $4,225 in Tulsa to $9,250 in Brooklyn for in-network care [8]. PPO plans often have separate limits for in-network and combined in- and out-of-network costs. The Flagstaff PPO sets a $6,800 in-network MOOP and a $7,900 combined limit [8].
All Part D plans include an out-of-pocket maximum of $2,100 for prescription drugs in 2026 [8][9]. After reaching this threshold, you enter catastrophic coverage and pay $0 for covered medications the rest of the year [9].
Income-Based Part B Premium Adjustments (IRMAA)
Your Medicare Part B premium increases if your income exceeds certain thresholds. The Social Security Administration determines IRMAA based on your income from two years prior, so your 2026 IRMAA reflects your 2024 tax return [6][10].
Single filers earning more than $109,000, or joint filers earning more than $218,000, see Part B premiums jump to $284.10 per month [6][6]. The surcharges escalate across five income brackets, reaching $689.90 for individuals earning $500,000 or more [6][6].
Part D also carries IRMAA surcharges ranging from $14.50 to $91.00 per month, depending on income [6][10]. Part B IRMAA gets added to your premium bill, but you must pay Part D IRMAA directly to Medicare [6].
Hidden Costs To Watch For
Several expenses can catch you off guard beyond standard copays and premiums. Emergency room visits cost $130 as a copay on some plans, though this is waived if you’re admitted to the hospital within 24 hours [7]. Other plans charge $65 for ER visits [6].
Acupuncture for chronic low back pain costs $40 per visit and is limited to 20 visits per year [7]. Skilled nursing facility stays are free for days 1-20 but jump to $29 per day for days 21-100 [6]. Urgent care center visits range from $45 to higher, depending on your plan [6].
Certain services don’t count toward your maximum out-of-pocket limit. These include routine dental, fitness programs, and meal benefits [6]. Prior authorization requirements can delay or deny coverage for specific items and services [6].
If you have individual-specific help needs navigating Humana Medicare Advantage plans in Alabama, Arizona, California, Florida, Georgia, Illinois, Indiana, Louisiana, Mississippi, Nevada, Texas, and Virginia, call us at (877) 808-2900 or visit www.ONealInsuranceGroup.com. You can also follow us on Facebook and YouTube for ongoing Medicare guidance.
Humana Plan Types: Which One Fits Your Needs
Humana offers four main plan structures. Each one is designed for different healthcare needs and budget priorities.
Gold Plus HMO Plans: Lower Costs With Network Restrictions
Humana’s Gold Plus HMO plans require you to select a primary care physician from their network to coordinate your care and provide specialist referrals [9]. You’re covered for unlimited visits with your PCP and can switch to a new one whenever needed [9].
You must use in-network providers except in emergencies, but HMO plans feature lower monthly premiums and copays than other plan types [9]. This structure works well if you’re comfortable staying within a defined network and prefer predictable costs.
PPO Plans: Pay More For Provider Freedom
Humana’s PPO plans let you visit any Medicare-approved doctor who accepts the plan’s terms without requiring referrals [11]. You’ll pay less when using in-network providers, but out-of-network care remains available at higher costs [11].
PPO plans typically have higher monthly premiums [11]. This option suits those who value provider choice or have relationships with specialists outside Humana’s network.
Special Needs Plans For Chronic Conditions
Chronic Condition Special Needs Plans (C-SNP) serve members with qualifying health conditions like diabetes, chronic kidney disease, cardiovascular disease, chronic heart failure, and chronic lung disease [7]. Many Humana C-SNPs offer $0 copays on hundreds of prescriptions to manage these chronic conditions [7].
Members receive the Healthy Options Allowance to cover eligible groceries, utility bills, and rent. Unused balances roll over monthly [7]. You’ll also get a traditional OTC allowance for vitamins, pain relievers, and first aid supplies [7]. Your doctor must verify your qualifying condition within 60 days of enrollment [7].
Dual Eligible Plans For Medicare And Medicaid Members
D-SNPs combine Medicare and Medicaid benefits into one plan for dual-eligible members [12]. Many Humana D-SNPs feature $0 copays for all covered Part D prescriptions with no deductible. This includes brand-name drugs [12].
These plans include dental and vision coverage plus monthly OTC allowances [12]. Members meeting certain criteria may access Special Supplemental Benefits for the Chronically Ill to help with groceries, utilities, and rent [12].
For customized guidance on selecting the right Humana plan in Alabama, Arizona, California, Florida, Georgia, Illinois, Indiana, Louisiana, Mississippi, Nevada, Texas, and Virginia, call us at (877) 808-2900 or visit www.ONealInsuranceGroup.com. Follow us on Facebook and YouTube for ongoing Medicare support.
What Humana Medicare Advantage Plans Cover
Humana Medicare Advantage plans provide coverage that goes well beyond the hospital and medical services of Original Medicare and add supplemental benefits that address everyday health needs.
Hospital And Medical Service Coverage
All Humana plans cover unlimited inpatient hospital days, though you must notify the plan before admission, except during emergencies [6]. Plans include preventive services such as abdominal aortic aneurysm screening, annual wellness visits, cardiovascular disease screening, and depression screening at no cost [6]. Emergency room visits require a copay that is waived if you are admitted within 24 hours [6].
Prescription Drug Formularies And Restrictions
Humana organizes prescription drugs into cost-sharing tiers and updates formularies each month [10]. Certain medications require prior authorization before coverage approval. Quantity limits restrict the amount dispensed for specific drugs [13]. The formulary may change during the year, and affected members receive a 30-day notice before modifications [10].
Dental, Vision, And Hearing Benefits Details
Every 2026 Humana Medicare Advantage plan has routine dental, vision, and hearing care [3]. Dental coverage provides up to $1,000 each year for preventive and diagnostic benefits, including cleanings and exams [6]. Plans cover two cleanings each year, with 86% offering periodontal scaling [14].
Gym Memberships And Fitness Program Access
Many Humana Medicare Advantage plans may also include Part B, a give-back, a food card, dental, vision, and SilverSneakers at no additional cost [15]. This program provides access to about 14,000 participating locations nationwide, including gyms, recreation centers, and community facilities [16].
Transportation And Meal Delivery Services
Eligible members receive post-discharge meal benefits and chronic-condition meal programs through vendors such as Mom’s Meals [17]. All meals arrive ready to heat and eat, last up to 14 days refrigerated, and offer dietitian-designed options for specific health needs [4].
Is Humana Medicare Advantage A Good Plan: Pros, Cons, And Ratings
To determine whether Humana Medicare Advantage meets your needs, you must weigh affordability against quality performance metrics that reveal how well the company serves its members.
Advantages: Low Premiums And Part B Giveback
Humana offers more giveback plans than any other major carrier [18]. About 1,369 Medicare Advantage plans nationwide offer 2026 Part B premium reductions, and Humana offers many of these [19]. The standard Part B premium is $202.90 monthly [20]. Giveback amounts can range from as little as 10 cents to the full premium [19], though most fall between these extremes. You receive the reduction either as a lower deduction from your Social Security check or as a credit on your Medicare invoice [20].
Disadvantages: Below Average CMS Ratings
Humana’s average star rating sits at 3.61 for 2026 [9], well below the industry average of 4.02 [5]. Only 20% of Humana members are enrolled in plans rated 4 stars or above, down from 25% in 2025 [9][11]. This decline matters because plans rated 4 stars or higher receive bonus payments from CMS [11], which can translate to better benefits.
Third-Party Reviews: JD Power And NCQA Scores
Humana receives below-average customer satisfaction scores in 9 of 10 Medicare markets surveyed by JD Power [18]. The company ranked 2nd out of 6 in Florida [5], but placed 7th out of 8 in California and 5th out of 5 in Michigan [5]. It ranked last in both North Carolina and Ohio [5]. About 59% of Humana Medicare Advantage plans carry NCQA accreditation [5].
Common Complaints And Why Members Switch
Among members who left Humana, 19% cited problems with doctors or hospital networks, compared with the 17% industry average [5]. Financial issues affected 14% of departing members [5], while 4% reported prescription drug benefit problems, compared with 3% across all companies [5].
How Humana Compares To Devoted Health, Antham, AARP, UnitedHealthcare, and Aetna
While Humana has 20% of members in 4-star-plus plans [9], UnitedHealthcare maintains roughly 78% in this category [11], and Aetna stands at 81% [9]. But Humana’s enrollment grew by 1.2 million members while UnitedHealth lost over 530,000 [21].
Conclusion
Humana presents a compelling option if you’re prioritizing affordability and complete supplemental benefits. Most plans have $0 premium availability. Standard dental, vision, and hearing coverage is available. But the below-average star ratings give me pause. Only 20% of members are in 4-star-plus plans.
I’d recommend Humana if you value lower upfront costs and generous benefits. Understand that you might sacrifice some quality metrics compared with competitors such as UnitedHealthcare or Aetna. For customized guidance in Alabama, Arizona, California, Florida, Georgia, Chicago, Illinois, Indiana, New Orleans, Louisiana, Henderson, Summerlin, North Las Vegas, Jackson, Hattiesburg, Petal, Gulfport, Laurel, Biloxi, Pascagoula, Ocean Springs, Moss Point, Mississippi, Nevada, Texas, and Virginia, call us at (877) 808-2900 or visit www.ONealInsuranceGroup.com, and follow us on Facebook and YouTube.
FAQs
Q1. What are the monthly premiums for Humana Medicare Advantage plans in 2026? About 66% of Humana Medicare Advantage plans have a $0 monthly premium. For plans that do charge a fee, the average is $26.88 per month. However, you must still pay the standard Medicare Part B premium of $202.90 monthly, regardless of which plan you choose. Some Humana plans offer a Part B premium reduction that can lower this cost by up to $1.00.
Q2. Which Medicare Advantage company has the highest quality ratings for 2026? Aetna and UnitedHealthcare lead in quality ratings, with approximately 81% and 78% of their members enrolled in 4-star-plus plans, respectively. In comparison, Humana has only 20% of members in 4-star-plus plans, with an average rating of 3.61 out of 5, which is below the industry average of 4.02 stars.
Q3. What are the main disadvantages of choosing a Humana Medicare Advantage plan? The primary drawbacks include below-average CMS star ratings and customer satisfaction scores. Humana ranks lower than competitors in most JD Power surveys, with 19% of departing members citing network issues and 14% reporting financial concerns. Additionally, only 20% of Humana members are in highly-rated 4-star-plus plans.
Q4. How does Humana compare to UnitedHealthcare for Medicare Advantage coverage? While UnitedHealthcare maintains higher quality ratings, with 78% of members in 4-star-plus plans, Humana offers more affordable options, with 66% of plans at a $0 premium and more Part B giveback plans than any other major carrier. Humana gained 1.2 million members in 2026 while UnitedHealthcare lost over 530,000, suggesting strong value despite lower ratings.
Q5. What prescription drug costs can I expect with Humana Medicare Advantage in 2026? Nearly all Humana plans offer $0 copays for Tier 1 preferred generic drugs, with 99.2% of plans including this benefit. Tier 2 generics average $5.68 out-of-pocket, while Tier 3 preferred brands cost around $44.34. Insulin is capped at $35 per month, and all Part D plans include a $2,100 annual out-of-pocket maximum, after which you pay $0 for covered medications.
References
[1] – https://policy.humana.com/news-and-resources/news-press/2025/humana_s-2026-medicare-advantage-plans-prioritize-simplicity-
[2] – https://finance.yahoo.com/news/humana-2026-medicare-advantage-plans-110000902.html
[3] – https://www.humana.com/medicare/medicare-advantage-plans
[4] – https://provider.humana.com/patient-care/health-programs/meal-delivery-benefit
[5] – https://www.nerdwallet.com/insurance/medicare/humana-medicare-advantage-review
[6] – https://assets.humana.com/is/content/humana/SB079188EN26pdf
[7] – https://www.humana.com/medicare/medicare-advantage-plans/humana-special-needs/c-snp
[8] – https://www.healthline.com/health/medicare/humana-medicare-advantage-plans
[9] – https://www.fiercehealthcare.com/regulatory/2026-ma-star-ratings-aetna-humana-see-score-decline-unitedhealthcare-improves
[10] – https://assets.humana.com/is/content/humana/20260015PDG2640826Cpdf
[11] – https://www.healthcaredive.com/news/humana-2026-medicare-advantage-star-ratings-slip/801839/
[12] – https://www.humana.com/medicare/medicare-advantage-plans/humana-special-needs/d-snp
[13] – https://www.pbucc.org/images/pbucc/publications/Health/AdvantagePlan/2026-Humana Kit/humana-prescription-drug-guide-2026.pdf
[14] – https://assets.humana.com/is/content/humana/Dental Office Handbook 2026pdf
[15] – https://www.humana.com/medicare/medicare-resources/silver-sneakers-and-medicare
[16] – https://www.medicare.org/articles/what-is-the-silversneakers-program/
[17] – https://www.humana.com/home-care/well-dine
[18] – https://www.nerdwallet.com/insurance/medicare/best-medicare-advantage-plans
[19] – https://www.medicareresources.org/medicare-eligibility-and-enrollment/how-the-medicare-part-b-giveback-might-save-you-money/
[20] – https://www.humana.com/medicare/medicare-resources/part-b-giveback-benefit
[21] – https://www.healthcaredive.com/news/medicare-advantage-plans-2026-unitedhealthcare-humana-aetna/801761/
