What is a Medicare Advantage Plan?
A Medicare Advantage Plan is an alternative to Medicare Parts A and B. It is offered through private insurance companies but approved by Medicare. Most Medicare Advantage Plans have enhanced benefits, limits on out-of-pocket expenses, and worldwide coverage for emergency and urgently needed care. Some even have extra services, fixed costs, and prescription drug benefits. You’ll still have Medicare, but Part A (Hospital Insurance) and Part B (Medical Insurance) coverage will come from the Medicare Advantage Plan instead of Original Medicare. To enroll in a Medicare Advantage plan you must have both Medicare Part A and Part B.
Can I enroll in more than one Medicare Advantage Plan?
No. You may only be enrolled in one Medicare Advantage plan at a time. Enrolling in a second Medicare Advantage Plan will disenroll you from the first.
Will I lose my Original Medicare if I join the Humana Medicare Advantage plan?
No. While on this plan, Humana replaces your Original Medicare benefits. However, you must continue to be enrolled in Medicare Part A and B and must still pay your Part B premium to Medicare. If at any time you lose or cancel coverage from the Humana Medicare Advantage Plan, you will return to Original Medicare. Please notify your benefits administrator if you decide to cancel your coverage.
I am eligible for Medicare, but have not yet applied for Medicare Part B. When can I enroll in the Humana plan?
To join this plan you must have Medicare Part A and B. Once you receive your Medicare effective dates, you may enroll into this plan.
What plans can I choose from with Humana?
East Baton Rouge Parish School System worked with Humana to create benefit packages to meet your needs. You’ll have the choice between a Humana Medicare Advantage Employer HMO (Health Maintenance Organization) and PPO (Preferred Provider Organization) Plan.
What is the difference between the Medicare Advantage HMO and PPO Plan?
An HMO (Health Maintenance Organization) Plan features a specific list of doctors, hospitals and other providers that you must use to receive benefits, except in emergency situations. You will choose a primary care doctor and may need a referral from your primary care doctor for certain benefits and services. With a PPO (Preferred Provider Organization) Plan you may use both in and out of network doctors and hospitals as long as the out of network doctor or hospital accepts Medicare and agrees to bill Humana. The amount you pay may be higher when services are received from an out of network doctor or hospital. Referrals are not needed and you’re not required to choose a primary care doctor.
How much will it cost for the for the Humana Medicare Advantage plan?
For premium information, please see the Employee Rates section of this website.
Will I have to pay a copayment when I see my doctor or go to the hospital?
No. You will not be responsible for copayments on any medical benefit or service received as part of the Humana Medicare Advantage Plan.
How do I know which plan is right for me?
You will receive an informational kit in the mail from Humana. This kit will include plan benefits, covered services and other plan details which will help you choose the right plan. You will also be given the opportunity to attend seminars in late August and early September at the IRC (Instructional Resource Center). Humana Representatives will be at the seminars to help you choose the right plan for and answer questions you have about the plan or your specific needs.
How can I find out if my doctors are in Humana’s network?
A provider directory (listing of doctors near you in Humana’s network) will be mailed to you shortly after you receive your informational kit from Humana. You can search for your doctors in the directory to see if they are in-network. You may also find Humana providers online at humana.com.
How do I enroll in the plan?
East Baton Rouge School System will enroll you in the Humana Medicare Advantage Employer PPO Plan. If you would like to keep the Humana Medicare Advantage Employer PPO Plan there is nothing you need to do. If you do not want the Humana Medicare Advantage Employer PPO Plan, you will have the choice to “buy down” to the Humana Medicare Advantage Employer HMO Plan or “buy up” to the Blue Cross Blue Shield Plan you are currently enrolled in. Details including how to “buy up” or “buy down” will be sent with the informational packet from Humana.
When can I enroll in the Humana Medicare Advantage Plan?
You will be able to choose your plan during the initial Open Enrollment Period. An Open Enrollment Period is a range of dates when you are able to select, waive or change your Medicare Advantage Plan. The dates of your Open Enrollment Period for this year are October 14th through November 14th.
I am not Medicare eligible but my spouse/dependent is. Will my spouse/dependent be allowed to join The Humana Medicare Advantage plan?
Yes. If your spouse/dependent is enrolled in Medicare Parts A and B they may join this plan. You will remain with Blue Cross Blue Shield on your current coverage until you are Medicare eligible.
I am Medicare eligible but my spouse/dependent is not. Who will provide coverage to my spouse/dependent when I join Humana?
When you move to the Humana Medicare Advantage Plan, your spouse/dependent will remain with Blue Cross Blue Shield on their current plan until they are also Medicare eligible.
I am a Medicare eligible surviving spouse/ dependent. May I join the Humana Medicare Advantage Plan through EBRPSS?
Yes. If you are a surviving spouse/dependent and currently have coverage through EBRPSS, you may join this plan.
If I receive “extra help” from Medicare to pay for my prescription drugs can I still join the Humana Medicare Advantage Plan?
Yes. If you receive “extra help” from Medicare (also known as low-income subsidy) you can still enroll in this plan. Humana and Medicare will work together to make sure you receive prescription drugs at the lowest cost possible.
To see if you qualify for getting extra help, call:
1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week; and see http://www.medicare.gov ‘Programs for People with Limited Income and Resources’ in the publication Medicare & You.
The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call 1-800-325-0778 or Your State Medicaid Office.
What if I need more information or have a question that I need answered before the seminar?
You may contact Humana at 1-800-824-8242 (TTY: 711). When you call be sure to mention that you are eligible through East Baton Rouge Parish School System.