Humana Medicare Advantage Review (2026): Cost, Pros & Cons

Humana covers four Medicare Advantage plan types: HMO, HMO-POS, PPO and PFFS. Each plan type determines how you access care and which providers you can see, though availability varies by state.

• HMO: HMO plans require you to choose a primary care doctor who coordinates your care and refers you to specialists. You must use in-network providers except for emergency care. These plans have among the lowest premiums but restrict access to in-network providers for non-emergency care.
• HMO-POS: HMO-POS plans use the same in-network structure as HMOs. The key difference is out-of-network access: you can see out-of-network providers without a referral, at a higher cost share. Out-of-network care costs more, though coverage is available when you need it.
• PPO: PPO plans let you see any Medicare-approved provider without referrals. In-network care costs less, and out-of-network care is covered at a higher cost share. PPO plans suit members who want to choose their own providers without coordinating through a primary care doctor.
• PFFS: PFFS plans allow you to visit any Medicare-approved provider who accepts the plan's payment terms. No referrals are required and there's no provider network requirement. Not all doctors accept PFFS plans, so confirm acceptance before each appointment.

Humana's Medicare Advantage plans are available in 46 states and Washington, D.C. Texas has 50 plans across HMO, PPO and PFFS tiers, and Florida has 40.

Connecticut, Delaware, Massachusetts, Minnesota, Vermont, Wyoming and Washington, D.C. have PPO plans only, with no HMO or HMO-POS options. Seniors in those states pay Humana's average PPO out-of-pocket maximum of $7,200 and can't access the lower $4,856 HMO ceiling. Texas has more Humana Medicare Advantage plans than any other state at 50, across HMO, PPO and PFFS tiers.

Humana's Medicare Advantage plans earn an average CMS Star Rating of 3.66 out of 5, 0.15 below the national average of 3.81. CMS star ratings score each plan on care effectiveness and member experience. Care coordination and health outcomes are measured alongside member satisfaction and customer service.

Humana's HMO-POS deviation of 0.44 below the national average is nearly twice the PPO gap of 0.23 and more than three times the HMO gap of 0.13.

For members managing an ongoing condition, that HMO-POS gap is the number that should drive the plan-type decision. Care coordination and health outcome scores are where the 0.44 deviation surfaces most directly. Healthy members who rarely use care are unlikely to notice the 0.44 gap. 

The Medicare Plan Finder at medicare.gov lists county-level CMS Star Ratings for every Medicare Advantage plan available in your area. Humana's statewide HMO-POS average of 3.57 covers all counties where the plan is available, your county's rating is in the Plan Finder.

Sixty-five percent of Humana Medicare Advantage plans have $0 monthly premiums, based on MoneyGeek's analysis of CMS data. The average monthly cost across all plan types is $25.

Humana's HMO tier has the lowest annual exposure ceiling at $4,856, $51 below the national HMO average. PFFS plans have a $27 average premium against the PPO average of $14. The PFFS out-of-pocket maximum of $6,578 is $622 below the PPO ceiling of $7,200. The trade-off is $156 more annually in premiums for $622 less in annual exposure than the PPO tier.  

PPO plans average $14 per month and cover any Medicare-approved provider without referrals, with no requirement to coordinate care through a primary care doctor. The average PPO out-of-pocket maximum is $7,200, $934 above the national PPO average of $6,266.

A senior who reaches the $7,200 PPO ceiling pays $2,344 more per year than a Humana HMO member at the $4,856 cap. Members expecting frequent specialist visits or ongoing prescriptions will spend at most $4,856 annually on the HMO, $2,344 below the PPO ceiling.

Humana's Medicare Advantage plans include dental and vision benefits that Original Medicare doesn't cover. Most plans also include hearing coverage and Part D prescription drug benefits, with $0 copays for Tier 1 and Tier 2 medications at preferred pharmacies. Plan-level benefit limits vary by county. Check the Summary of Benefits for your specific plan to confirm dental caps, hearing aid coverage and any cost-sharing that applies before enrolling.

• Dental coverage: Most Humana plans, including the Humana Gold Plus HMO series, include dental benefits covering preventive care such as cleanings and X-rays, plus restorative services including fillings, crowns and deep cleanings. Annual dental benefit caps vary by plan and county. Check the Summary of Benefits for your plan to confirm restorative coverage limits before enrolling.
• Vision and hearing benefits: All 2026 Humana plans include routine vision coverage for eye exams and eyewear. Hearing benefits cover exams and hearing aids. Original Medicare doesn't cover hearing aids. Without coverage, hearing aids cost $3,000 to $6,000 per device.
• Prescription drug coverage: Most Humana Medicare Advantage plans, including HumanaChoice PPO plans, include Part D drug coverage. Many plans have $0 copays for Tier 1 and Tier 2 medications at preferred pharmacies, covering most generics at no cost.
• Primary care and preventive services: Many plans feature unlimited primary care visits with $0 copays at in-network providers. Preventive services, including mammograms, colonoscopies, bone density exams and routine vaccines, are also covered at $0.
• Special Needs Plans: Humana's Institutional Special Needs Plans (I-SNPs) include additional care coordination support, music therapy sessions designed by certified therapists and transportation benefits for members with chronic conditions.

Humana Medicare Advantage plan availability varies by state and county. Use the table to review options in your area and compare coverage across plan types:

Seniors in Connecticut, Delaware, Massachusetts, Minnesota, Vermont, Wyoming and Washington, D.C. have no access to Humana's HMO tier, where the average out-of-pocket maximum is $4,856.

Every member in those seven states starts with a $7,200 annual cost-sharing ceiling. Humana's PPO plans earn a 3.86 CMS Star Rating, above the national average of 3.63, but the $7,200 MOOP plus deductible is $2,344 higher than the $4,856 HMO floor available in other states.

All ten Florida HMO plans shown have $0 monthly premiums, but their out-of-pocket maximums range from $500 to $3,200. The Humana Gold Plus H1036-054C plan's $500 maximum is the lowest among these plans, a $2,700 difference from the highest ceiling of $3,200.

Humana earns a 4.4 out of 5 MoneyGeek score. Its HMO plans average $3 monthly, $23 below the national HMO average of $26, with 83% having $0 premiums. Seniors who want premiums at or near $0 and are comfortable with a restricted network are well matched to Humana's HMO tier at $3 monthly on average.

Seniors who prioritize plan quality over annual ceiling size can get a 3.86-star PPO from Humana at $14 monthly, though the $7,200 out-of-pocket maximum exceeds the national PPO average by $934. Those who need to keep annual exposure below $5,000 will find better footing in Humana's HMO tier, where the average ceiling is $4,856. 

Humana's HMO-POS tier is the lowest-rated plan type in the portfolio. Members with chronic conditions or frequent care needs will receive care coordination at that lower rating. County-level scores at medicare.gov show whether your local HMO-POS rating differs from the statewide figure.

MoneyGeek's scoring system rates Medicare Advantage plans on quality, affordability and availability across the U.S. The 2026 dataset covers all Medicare Advantage contracts, sourced from the Centers for Medicare & Medicaid Services plan landscape files. Our dataset covers premiums, out-of-pocket maximums and CMS Star Ratings across every plan type: HMO, HMO-POS, PPO and PFFS, in all 46 states where Humana participates.

Scoring System

Our methodology evaluates three factors to identify plans that provide the best value for your health care needs:

• Affordability (50%): Cost makes up half of our overall score because it directly affects your budget. Monthly premiums for Part C and Part D coverage combined have 30% of the total score. In-network maximum out-of-pocket limits account for the remaining 20%.
• Star Ratings (40%): CMS ratings score each plan on care effectiveness and member experience, covering how well the plan coordinates care and resolves member issues. The Overall Star Rating combines both Part C (medical coverage) and Part D (prescription drug) ratings on a scale from 1 to 5 stars.
• Availability (10%): Geographic reach accounts for the remaining 10%. Providers available in more states are more likely to maintain coverage if you move and can invest more in customer support and plan improvements.