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Humana vs Aetna: Which is Best for Medicare?

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Humana vs Aetna: Which is Best for Medicare?

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Although Medicare is a national health insurance program, private health insurance companies like Humana and Aetna provide benefits to people. That means you can get slightly different prices and services depending on whether you get Medicare through Humana or Aetna.

Before you commit to Medicare for your health insurance, compare your options from two of the country's biggest insurance companies to make sure you choose the better plan for your needs.

Keep in mind that health insurance plans can vary based on where you live. While this article offers some basic comparisons between Humana and Aetna Medicare plans, you should contact local providers for more detail.

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Humana and Aetna Medicare Part A Plans

For the most part, Medicare Part A offers the same benefits and prices regardless of whether you choose Humana or Aetna as your health insurance provider. Medicare Part A follows federal rules that help ensure consumers get the services they need for hospital and hospice stays.

Medicare Part A covers the major services that you need when you're in the hospital, homebound, or staying in a hospice center. The covered services include:

  • Lab tests, such as blood work and imaging.

  • At-home nursing care.

  • Hospital meals.

  • Semi-private hospital rooms.

  • Medical supplies, equipment, and drugs needed during your hospital stay.

  • Charges for operations and recovery.

  • Rehab services, such as physical therapy.

The federal government sets prices for Medicare Part A plans, so you will pay the same amount whether you choose Aetna or Humana. Assuming that you have at paid into the Medicare system for at least 10 years of your working life, you should qualify for a zero-premium plan. With a zero-premium plan, you don't have to pay any monthly or annual costs.

If you haven't met Medicare's requirements, you can purchase when you turn 65 years old. Plans cost up to $458 per month, depending on how much Medicare taxes you have paid over your life.

Medicare Part A Deductibles

Humana and Aetna will hold you responsible for an annual deductible each year. The companies will not start paying your bills until you reach the deductible. 

For 2020, Medicare Part A has an inpatient hospital deductible of $1,406. The specific amount changes by year, so always check to make sure you know the most current deductible.

Medicare Part A Co-payments

Medicare Part A from Humana and Aetna also comes with cost sharing co-payments. If you need to spend more than 60 days in a hospital, you can expect to make a daily$352 co-payment until the 90th day. After the 60th day, you will pay $704 per day. For nursing services in a facility, Medicare Part A requires a $176 per day co-payment.

Like deductibles, Medicare Part A co-payments change each year.

Humana and Aetna Medicare Part B Plans

Medicare Part B helps pay for expenses that Medicare Part A does not cover. Most of the coverage applies to at-home and outpatient services. Other services covered by Medicare Part B include:

  • Chiropractic care.

  • Preventive services.

  • Durable medical equipment (DME).

Like Medicare Part A, Part B has prices set by the U.S. government. Medicare Part B is considered a core aspect of the original Medicare plan. 

The monthly cost of Medicare Part B varies depending on your income. For 2020:

  • Individuals earning up to $87,000 (couples earning up to $174,000) pay $144.60.

  • Individuals who make $87,001 to $109,000 (couples who make $174,001 to $218,000) pay $202.40.

  • Individuals earning $109,001 to $136,000 (couples earning $218,001 to $272,000) pay $289.20.

  • Individuals with income between $136,001 and $163,000 (couples earning $272,001 to $326,000) pay $376.

  • Individuals earning $163,001 to $499,999 (couples earning $326,001 to $749,999) pay $462.70

  • Individuals who make $500,000 or more (couples who make $750,000 or more) pay $491.60.

Humana and Aetna Medicare Advantage Plans (Part C)

The differences between Humana and Aetna become more noticeable when you start exploring Medicare Part C plans, also known as Medicare Advantage Plans.

Medicare Advantage Plans are private insurance meant to complement health insurance from the federal government by filling in coverage gaps. Individuals can choose specific plans that match their unique needs instead of choosing generic plans designed for the general public.

Because these plans come from private insurers, they offer a variety of coverage options. Some of the most popular Medicare Advantage Plans include:

  • Health Maintenance Organization (HMO) Plans

  • Private Fee-for-Service (PFFS) Plans

  • Preferred Provider Organization (PPO) Plans

  • Special Needs Plans (SNPs)

Each of these plans has pros and cons that may influence whether they match your health needs well.

Health Maintenance HMO Plans

HMO plans pay the most when you see a doctor or specialist within your insurance network. You will need to choose a primary care physician for regular health visits and referrals to specialists.

Most HMO plans will pay a percentage of your out-of-network costs. Most also cover prescription drugs.

Private Fee-for-Service (PFFS) Plans

PFFS plans have built-in flexibility that usually lets you choose the doctors and specialists that you want to see. You don't need to select a primary physician for routine visits or referrals. Most PFFS plans cover prescription drugs.

Preferred Provider Organization (PPO) Plans

PPO plans let you see any doctor or specialist, but they cover a higher percentage of the cost when you visit a doctor within the insurance network. You do not need to choose a primary care physician. You don't need referrals to see specialists. In most cases, PPO plans cover prescription drugs.

Special Needs Plans (SNPs)

SNPs are plans made for people with specific healthcare needs. For instance, someone with a cardiovascular disorder might benefit from an SNP that pays for treatments and tests related to the chronic condition.

Humana or Aetna for Medicare Part C Advantage Plans

Humana and Aetna Medicare Advantage Plans differ from state to state, so where you live will influence which option you choose. In some areas, you might not find Medicare from both insurance providers.

U.S. News & World Report lists Aetna as one of the best Medicare Advantage providers in seven states. It does not include Humana in its list of top-performing Medicare providers. Keep in mind, however, that the publication does not include Medicare Advantage plans from every state.

Humana and Aetna Medicare Part D Plans

Medicare Part D covers prescription drugs. Co-payments for prescription drug medications fall into four categories:

  • Tier 1, which has the lowest co-payment and covers most generic drugs.

  • Tier 2, which has a medium co-payment for proffered, brand-name prescription drugs.

  • Tier 3, which has higher co-payment for non-preferred, brand-name prescription drugs.

  • Specialty Tier, which charges the highest co-payment for very expensive prescription drugs.

No matter which insurance provider you choose, you will pay a monthly premium and co-payments when you buy medications. You also need to meet an annual deductible before your insurance will cover the cost of drugs.

How much you spend on Medicare Part D can vary significantly from person to person.

Humana and Aetna routinely get mentioned as top-10 Medicare Part D providers, so you should get price quotes from both companies. Also, make sure you look carefully at what drugs your policy will pay for. Humana and Aetna don't have to put drugs in the same tiers, so a drug that one company schedules as Tier 2 may be considered Tier 3 by the other provider.

Find the Right Medicare Plan for You

When it comes to Medicare Part A and Part B, you can largely rely on insurance providers to provide the same level of coverage at the same price. That doesn't mean both companies will give you the same level of service, though.

Before you choose between Humana and Aetna as your Medicare provider, learn more about how your regional and local offices perform. You may discover that one company has a better reputation than the other.

Selecting an insurance provider matters more when you buy Medicare Advantage, Medicare Supplement and Part D plans. With these options, companies can charge different prices and cover slightly different services. Since insurance providers can create their own plans, you will find a lot of variety. Even the same company may have several options listed at different prices. All of the policies must fall within federal guidelines, but the government gives them plenty of room for innovation and diversity.

If possible, find local reviews from patients who use Medicare from Humana and Aetna. You want a low-cost plan that covers your medical expenses, but you also want to find a company that processes requests quickly and offers excellent customer services.

Humana or Aetna could have Medicare plans that meet your unique health needs. Get price quotes and learn more about your coverage options before you commit to a plan. Getting more details about Medicare plans will help you make an informed choice.

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