HumanaOne Traditional PPO Plans - Illinois
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Our HumanaOne Commentary
We offer some perspectives on HumanaOne traditional PPO products for Illinois residents. We'll also touch on meaningful considerations not typically addressed in insurance company marketing materials.
Range of Benefits
Humana has designed traditional PPO health insurance products providing a range of benefits from "relatively generous" to "moderate" to "lean." All these plans provide solid comprehensive major medical coverage with emphasis on preventive care and prescription benefits.
Humana's products are designed for the "middle market." If you're inclined to spend extra for lavish benefits or if you want minimal coverage at the cheapest cost, you're not a HumanaOne target consumer.
PPO Network
The Humana/ChoiceCare PPO is a widely recognized national network owned by Humana. You'll find participating doctors and hospitals throughout the USA. In Illinois, the Humana/ChoiceCare network isn't as extensive as the Blue Cross and Blue Shield of Illinois PPO, but it's still ranks as one of the state's better networks.
Medical Underwriting
We give Humana a strong "thumbs up" for their medical underwriting practices. They're fast and fair.
With streamlined administration, Humana keeps your application processing time to a minimum.
In addition, Humana isn't a "strict" medical underwriter. Many of our clients who've been rejected by Blue Cross and Blue Shield of Illinois have been able to obtain more favorable outcomes with Humana, which is, in general, more accommodating to those with ongoing medical issues that are not life-threatening.
If your health history causes insurability concerns, we recommend HumanaOne's phone-in application, which gives you an opportunity to explain your health issues to an actual person (as opposed to describing a complex medical condition by writing a few short lines on an insurance form). In our view, the HumanaOne phone-in application results in a more accurate evaluation of your medical history.
On the other hand, if you're a smoker, HumanaOne should be one of your last choices, as they assess a huge additional charge to tobacco users. In addition, Humana is not particularly accommodating to those with obesity issues.
Adjusted Rates and Exclusion Riders
Depending on your health history, Humana may require an additional charge over the standard insurance premium typically quoted over the internet. For example, Humana often assesses an additional rate to those with chronic allergies.
In addition, Humana occasionally places medical condition-specific exclusion riders (amendments) on their health insurance contracts. For example, in underwriting someone who's experienced multiple episodes of basal cell carcinoma, Humana may exclude the condition from coverage.
Most other health insurance companies also use adjusted rates and exclusion riders in their medical underwriting. Our experience is that Humana tends to be more customer-friendly, less frequently applying these alterations to their standard health insurance policies.
Pre-Existing Conditions
Humana will waive the pre-existing condition limitation for medical conditions disclosed on the application, provided benefits for those conditions are not already excluded under the policy. Compared to most of Humana's competitors, this is a customer-friendly practice.
Conditions specifically excluded by rider aren't covered.
Customer Service
Humana introduced the HumanaOne products not so many years ago, and they built their supporting administrative organization from scratch. So, compared to most other health insurance companies, Humana is modern and efficient.
Humana claims payment consistently ranks high in timeliness and in accuracy. Also, doctors seem to find it easier to do business with Humana, and that can only help the patient experience.
HumanaOne phone hold times are generally short and Humana representatives are, in our view, well-trained and knowledgeable.
