medicare advantage plans louisiana...external agent success-metairie retail office location staffed...

MEDICARE ADVANTAGE PLANS

Select the market(s) below to view their Market HighlightsLOUISIANA

MA/MAPD PLANS

Humana offers a wide range of affordable plans and a broad network of healthcare providers nationwide to meet the unique needs of your clients. Many plans come with low or no monthly plan premium, plus health-boosting benefits that aim to help your clients achieve their best health.

LAHK7GUEN

DSNP AND VALUE PLUS PLANS

LOUISIANA


PRESCRIPTION DRUG PLANS

LOUISIANA

PDP PLANS

Humana offers affordable prescription drug plans that meet the unique needs of your clients. Our vast network includes mail-order pharmacies like Humana Pharmacy, which offers mail-order copays as low as $0 on generic drugs in many regions. In-store copays as low as $1 on certain generic drugs at Walmart, Sam’s Club, and Walmart Neighborhood Markets, which are preferred cost sharing pharmacies.

LOCAL SUPPORT

LOUISIANA

LOCAL SUPPORT

Humana now offers two new resources, Broker Relationship Managers (BRM) and Broker Relationship Executives (BRE), in addition to your local market offices. BRMs have been deployed in markets across the country to offer on-the-ground assistance, BREs to provide sales support telephonically and electronically. We encourage you to contact these resources or simply contact Humana Agent Support at 1-800-309-3163.


MARKET HIGHLIGHTS• Flagship HMO with $0 Plan Premium, NEW

$0 PCP copay, NEW $0 RX deductible and a Reduced Specialist Copay-Large Provider Network

• Enhanced DSNP HMO Plan with Robust Supplemental Benefits for QMB, QMB+, SLMB+ and FBDE Beneficiaries-Large Provider Network

• Exclusive Ochsner ONLY Network $0 Plan Premium HMO with a Robust Benefit Structure

• Referrals to specialists not required/needed on Louisiana Humana HMO plans

• Local marketing/training support to facilitate external agent success with a convenient retail office location staffed by local leadership and available to external agents

• Local Humana Guidance Center offering health education, SilverSneakers classes, customer service support, social activities and more - open to medicare members and community

• Improved dental, hearing and OTC allowance on several plans—HMOs Include SilverSneakers, Go365 member rewards program, Nurse Advice Line, Web/Telemedicine visit benefit

• Strong Humana brand recognition throughout the Baton Rouge market

NETWORK HIGHLIGHTS• Ochsner Health System hospitals/facilities/

clinics/providers in network—New facility on Highland Road-Baton Rouge

• The Baton Rouge Clinic participates in the Humana HMO and PPO networks

• Major facilities include but not limited to: Point Coupee, OHS, Baton Rouge General, Women’s Hospital, Our Lady of the Lake, Prevost, St. Elizabeth, West Feliciana Hospital

• All PPO plans have National Network Reciprocity—members may use any Humana PPO Choice network provider in any state and services will be treated as in-network

MARKET SERVICE AREAAscension, East Baton Rouge, Livingston, West Baton Rouge

LOUISIANA BATON ROUGE

Plan Name Humana Total Care Advantage (HMO) Humana Gold Plus (HMO) Humana Gold Plus (HMO)

Plan Number H1951-039-000 H1951-048-001 H1951-030-000

Plan Highlights$0 plan premium Ochsner network only HMO plan with robust core and supplemental benefits

$0 plan premium HMO plan for beneficiaries shopping for value and robust core and supplemental benefits

$0 plan premium HMO MA only plan with dental OSB—ideal for veterans using VA for Rx and others with credible Rx coverage

Premium $0 $0 $0

PCP $0 $0 $5

Specialist $30 $35 $50

Referrals Required No No No

Inpatient Hospital $85 per day Days 1-10 $125 per day Days 1-10 $110 per day Days 1-10

Max Out-of-Pocket $3,400 In Network $3,700 In Network $6,700 In Network

Rx Deductible No Deductible No Deductible No Coverage

Rx Preferred

$0/$10/$47/$99/33%; $0 copay for tiers 1 & 2 through mail order for a 90 day supply from Humana Pharmacy


No Coverage

Key Extra BenefitsDental, Vision, Hearing, Fitness, OTC allowance $30/Quarter, Transportation

Dental, Vision, Hearing, Fitness, OTC allowance $50/Quarter

Vision, Hearing, Fitness, OTC allowance $30/Quarter

Market Service Area East Baton Rouge, Livingston, West Baton Rouge Baton Rouge Marketwide Baton Rouge Marketwide

LOUISIANA | BATON ROUGE MA/MAPD PLANS

Plan Name HumanaChoice (Regional PPO)

Plan Number R0110-001-000

Plan Highlights$0 plan premium MA only RPPO with $40 Part B premium giveback; great option for the veteran population

Premium $0

PCP $0

Specialist $35

Referrals Required No

Inpatient Hospital $195 per day Days 1-6

Max Out-of-Pocket $6,700 In Network

Rx Deductible No Coverage

Rx Preferred No Coverage

Key Extra Benefits Dental, Vision, Hearing, Fitness, OTC allowance $30/Quarter

Market Service Area Statewide in Louisiana, Mississippi

LOUISIANA | BATON ROUGE MA/MAPD PLANS


MARKET HIGHLIGHTS• Flagship HMO with new $0 plan premium, new

$0 PCP copay, new $0 RX deductible and a reduced specialist copay-large provider network

• Enhanced DSNP HMO Plan with Loaded Supplemental Benefits for QMB, QMB+, SLMB+ and FBDE Beneficiaries-Large Provider Network

• Exclusive Ochsner ONLY Network $0 Plan Premium HMO with a Robust Benefit Structure

• REFERRALS to Specialists NOT Required/Needed on Louisiana Humana HMO Plans

• Local Marketing/Training Support to Facilitate External Agent Success with a Convenient Retail Office Location staffed by Local Leadership and Available to External Agents

• Local Humana Guidance Center offering Health Education, SilverSneakers Classes, Customer Service Support, Social Activities & much more-Open to Medicare Members and Community

• HMOs have Improved Dental, Hearing and OTC Allowance—Also Included are SilverSneakers, Go365 Member Rewards Program, Nurse Advice Line and a Web/Telemedicine Visit Benefit

• Strong Humana Brand Recognition Throughout the Baton Rouge Market

NETWORK HIGHLIGHTS• Ochsner Health System Hospitals/Facilities/

Clinics/Providers IN-Network—New Facility on Highland Road Baton Rouge

• The Baton Rouge Clinic participates in the Humana HMO and PPO Networks

• Major Facilities Include but not Limited to: Point Coupee, OHS, Baton Rouge General, Woman’s Hospital, Our Lady of the Lake, Prevost, St. Elizabeth, West Feliciana Hospital

• All PPO Plans have National Network Reciprocity—Member may use any Humana PPO Choice Network Provider in Any State and Services will be Treated as IN-NETWORK

MARKET SERVICE AREAEast Feliciana, Iberville, Pointe Coupee, Saint Helena, West Feliciana

LOUISIANA BATON ROUGE NORTH

Plan Name Humana Total Care Advantage (HMO) Humana Gold Plus (HMO) Humana Gold Plus (HMO)

Plan Number H1951-039-000 H1951-048-002 H1951-030-000

Plan Highlights$0 plan premium Ochsner network ONLY HMO plan with Robust Core and Supplemental Benefits

$0 plan premium HMO plan for Beneficiaries Shopping for Value and Robust Core and Supplemental Benefits

$0 plan premium HMO MA Only plan with dental OSB-Ideal for veterans using VA for Rx and Others with Credible Rx coverage

Premium $0 $0 $0

PCP $0 $0 $5





Rx Deductible No Deductible No Deductible No Coverage

Rx Preferred



No Coverage




Market Service Area East Feliciana, Iberville, Saint Helena Baton Rouge North Marketwide Baton Rouge North Marketwide

LOUISIANA | BATON ROUGE NORTH MA/MAPD PLANS



Plan Highlights$0 plan premium MA Only RPPO with $40 Part B premium giveback; Great option for the veteran population

Premium $0

PCP $0

Specialist $35








LOUISIANA | BATON ROUGE NORTH MA/MAPD PLANS


MARKET HIGHLIGHTS• Flagship HMO with $22 Plan Premium, NEW $5

PCP Copay, NEW $0 Rx Deductible with a Large Provider Network

• Enhanced DSNP HMO with Loaded Supplemental Benefits for QMB, QMB+, SLMB+ and FBDE Beneficiaries-Large Provider Network


• Improved Dental—HMOs includes Vision, Hearing, SilverSneakers, OTC Allowance, Go365 Member Rewards Program, Nurse Advice Line and a Web/Telemedicine Visit Benefit

• Local Marketing/Training Support to Facilitate External Agent Success-Metairie Retail Office Location Staffed by Local Leadership and Available to External Agents

• Strong Humana Brand Recognition Throughout the Market

• Humana Owned Mail Order Pharmacy—$0 Rx Copay (90-Day Supply) Tier 1 & 2—All MAPD Plans

• Humana Metairie Guidance Center offering Health Education, SilverSneakers Classes, Customer Service Support, Social Activities & more—Open to Medicare Members and Community


Clinics/Providers IN-Network - New Facility on Highland Road Baton Rouge

• IN-Network providers include but not limited to: Family Doctor Clinic (Thibodaux), Haydel Clinic, Family Doctor (Houma)

• Major Facilities Include but not limited to: Terrebone General, Thibodaux Regional, Ochsner St. Anne, Lady of the Sea General

• All PPO Plans have National Network Reciprocity - Member may use any Humana PPO Choice Network Provider in Any State and Services will be Treated as IN-NETWORK

MARKET SERVICE AREAAssumption, Lafourche, Plaquemines, Saint James, St John The Baptist, Terrebonne

LOUISIANA BAYOU & RIVER PARISHES

Plan Name Humana Gold Plus (HMO) HumanaChoice (Regional PPO) HumanaChoice (Regional PPO)

Plan Number H1951-047-002 R0110-002-000 R0110-003-000

Plan Highlights$22 plan premium HMO plan for Beneficiaries Shopping for Value and Robust Core and Supplemental Benefits

$53 plan premium PPO plan with dental OSB, Statewide network with choice, Includes national network reciprocity

$87 plan premium PPO plan-dental/vision OSBs-Statewide network with choice-Includes national network reciprocity

Premium $22 $53 $87

PCP $5 $15 $15





Rx Deductible No Deductible $415 tiers 3-5 $400 tiers 4-5

Rx Preferred







Market Service Area Bayou & River Parishes Marketwide Statewide in Louisiana, Mississippi Statewide in Louisiana, Mississippi

LOUISIANA | BAYOU & RIVER PARISHES MA/MAPD PLANS




Premium $0

PCP $0

Specialist $35








LOUISIANA | BAYOU & RIVER PARISHES MA/MAPD PLANS


MARKET HIGHLIGHTS• Flagship $0 Plan Premium HMO with NEW $0

RX Deductible and Lowered PCP and Specialist Copays-Large Provider Network

• Enhanced DSNP HMO with Loaded Supplemental Benefits for QMB, QMB+, SLMB+ and FBDE Beneficiaries—Large Provider Network


• Improved Dental—HMO Includes Vision, Hearing, SilverSneakers, OTC Allowance, Go365 Member Rewards Program, 24/7 Nurse Advice Line and a Web/Telemedicine Visit Benefit

• Strong Humana Brand in the Monroe Market

• Humana Market Manager Highly Engaged with External Agents/Partners


• Robust Compliment of PPO Products including a NEW $40 Part B Premium Giveback on MA Only PPO Plan, good fit for veterans

NETWORK HIGHLIGHTS• Major Facilities Include but not limited to:

St. Francis, Glenwood Regional, University Health, Monroe Surgical, P&S Surgical, Richardson Medical, Moorehouse & Union General

• Robust Network of Primary Care including Physician Group of Louisiana, Northeast Louisiana Health Center and More

• Collaborative Relationships with Network Providers

• ALL PPO Plans have National Network Reciprocity—Member may use any Humana PPO Choice Network Provider in Any State and Services will be Treated as IN-NETWORK

MARKET SERVICE AREACaldwell, Catahoula, East Carroll, Franklin, Jackson, Lincoln, Madison, Morehouse, Ouachita, Richland, Tensas, Union, West Carroll

LOUISIANA MONROE

Plan Name Humana Gold Plus (HMO) HumanaChoice (PPO) HumanaChoice (Regional PPO)

Plan Number H1951-049-003 H5216-064-000 R0110-002-000

Plan Highlights$0 plan premium HMO plan for Beneficiaries Shopping for Value and Robust Core and Supplemental Benefits

$45 plan premium LPPO plan with broader network & national network reciprocity using the Humana Choice network


Premium $0 $45 $53

PCP $10 $5 $15






Rx Preferred







Market Service Area Monroe Marketwide Caldwell, Morehouse, Ouachita Statewide in Louisiana, Mississippi

LOUISIANA | MONROE MA/MAPD PLANS




Premium $0

PCP $0

Specialist $35








LOUISIANA | MONROE MA/MAPD PLANS


MARKET HIGHLIGHTS• Flagship $0 Plan Premium HMO with $0 PCP

Copay, NEW $0 Rx Deductible, NEW $3,700 MOOP and a Robust Provider Network


• Unique $0 Plan Premium Chronic-Condition SNP Plan (Diabetes, Congestive Heart Failure, Cardiovascular Disease) with Year-Round SEP Sales Opportunity and Robust Benefits

• Exclusive Ochsner ONLY Network $0 Plan Premium HMO with Robust Benefit Structure


• Local Humana Guidance Center offering Health Education, SilverSneakers Classes, Customer Service Support, Social Activities & much more-Open to Medicare Members and Community

• Local Marketing/Training Support to Facilitate External Agent Success-Convenient Retail Office Location Staffed by Local Leadership and Available to External Agents

• Strong Humana Brand Recognition Throughout the New Orleans Market


Clinics/Providers IN-Network

• Major Facilities Include but not limited to: East Jefferson, West Jefferson, Touro, Womans, Tulane, St. Theresa, Ochsner Baptist, Lakeside, N.O. East, St. Charles Hospital


• All PPO Plans have National Network Reciprocity - Members may use any Humana PPO Choice Network Provider in Any State and services will be treated as IN-NETWORK

MARKET SERVICE AREAJefferson, Orleans, Saint Bernard, Saint Charles

LOUISIANA NEW ORLEANS

Plan Name Humana Total Care Advantage (HMO) Humana Gold Plus (HMO) Humana Gold Plus - Diabetes and

Heart (HMO SNP)

Plan Number H1951-038-000 H1951-047-001 H1951-044-000

Plan Highlights$0 plan premium Ochsner ONLY network HMO plan with Robust Core and Supplemental Benefits

$0 plan premium HMO plan for Beneficiaries Shopping for Value and Robust Core and Supplemental Benefits

$0 plan premium Chronic Special Needs plan for Cardiovascular Disorders, Congestive Heart Failure, and Diabetes Mellitus

Premium $0 $0 $0

PCP $0 $0 $0





Rx Deductible No Deductible No Deductible No Deductible

Rx Preferred





Dental, Vision, Hearing, Fitness, OTC allowance $30/Quarter, Transportation

Dental, Vision, Hearing, Fitness, OTC allowance $20/Month, Transportation

Market Service Area Jefferson, Orleans, Saint Charles Jefferson, Orleans, Saint Charles Jefferson, Orleans

LOUISIANA | NEW ORLEANS MA/MAPD PLANS

Plan Name HumanaChoice (PPO)

Plan Number H5216-064-000

Plan Highlights$45 plan premium LPPO plan with broader network & national network reciprocity using the Humana Choice network

Premium $45

PCP $5

Specialist $45




Rx Deductible $400 tiers 4-5

Rx Preferred



Market Service Area Saint Bernard

LOUISIANA | NEW ORLEANS MA/MAPD PLANS


MARKET HIGHLIGHTS• Enhanced DSNP HMO with Loaded

Supplemental Benefits for QMB, QMB+, SLMB+ and FBDE Beneficiaries-Large Provider Network


• Local Marketing/Training Support to Facilitate External Agent Success with a Humana Sales Manager located in the Area

• Improved Dental Benefit-HMO also includes Vision, Hearing, SilverSneakers, OTC Allowance, Go365 Member Rewards Program, Nurse Advice Line and a Web/Telemedicine Visit Benefit

• Strong Humana Brand Recognition Throughout the North Shore Market

• Collaborative Physician Relationships and Highly Engaged Humana Network Support Team


• NEW $40 Part B Premium Giveback on the PPO MA Only Plan - Ideal for veterans Using VA for Drug Coverage and Other Beneficiaries with Credible Drug Coverage



• Major Facilities Include but not Limited to: Slidell Memorial, St. Tammany Parish, Lakeview, Fairway and Riverside Medical, Southern Surgical, Our Lady of Angels


• All PPO Plans have National Network Reciprocity—Member May use any Humana PPO Choice Network Provider in Any State and services will be treated as IN-NETWORK

MARKET SERVICE AREASaint Tammany, Washington

LOUISIANA NORTH SHORE


Plan Number H1951-028-000 H5216-064-000 R0110-002-000

Plan Highlights$26 plan premium HMO for Beneficiaries Shopping for Value and Robust Supplemental Benefits



Premium $26 $45 $53

PCP $10 $5 $15





Rx Deductible $400 tiers 4-5 $400 tiers 4-5 $415 tiers 3-5

Rx Preferred







Market Service Area North Shore Marketwide Washington Statewide in Louisiana, Mississippi

LOUISIANA | NORTH SHORE MA/MAPD PLANS




Premium $0

PCP $0

Specialist $35








LOUISIANA | NORTH SHORE MA/MAPD PLANS


MARKET HIGHLIGHTS• Flagship HMO with NEW $0 Plan Premium, NEW

$0 Rx Deductible and a Robust Provider Network • Enhanced DSNP HMO with Loaded

Supplemental Benefits for QMB, QMB+, SLMB+ and FBDE Beneficiaries-Large Provider Network


• Local Marketing/Training Support to Facilitate External Agent Success. Convenient Retail Office Location Staffed by Market Leadership and Available to our External Agents

• NEW Humana Guidance Center LITE offering Health Education, SilverSneakers Classes, Customer Service Kiosk, Social Activities and more—Open to Medicare Members & Community

• Improved Dental, Vision—HMO Includes Hearing, SilverSneakers, OTC Allowance, Go365 Member Rewards Program, 24/7 Nurse Advice Line and a Web/Telemedicine Visit Benefit

• Strong Humana Brand Recognition Throughout the Shreveport-Bossier City Market

• NEW $40 Part B Premium Giveback on the PPO MA Only Plan—Ideal for veterans Using VA for Drug Coverage and Other Beneficiaries with Credible Drug Coverage

NETWORK HIGHLIGHTS• Major Facilities Include but not Limited to:

Willis-Knighton Health, Christus Health, Specialist Hospital Shreveport, University Health Shreveport, Minden, North Caddo

• Solid Compliment of Primary and Specialty Care Network Providers

• ALL PPO Plans have National Network Reciprocity—Member May use any Humana PPO Choice Network Provider in Any State and services will be treated as IN-NETWORK


MARKET SERVICE AREABienville, Bossier, Caddo, Claiborne, DeSoto, Red River, Sabine, Webster

LOUISIANA SHREVEPORT - BOSSIER CITY


Plan Number H1951-013-000 H5525-015-000 R0110-002-000

Plan HighlightsFlagship $0 plan premium HMO plan for Beneficiaries Shopping for Value and Robust Core and Supplemental Benefits

$45 Plan Premium LPPO Plan with a Broad Network & National Network Reciprocity using the Humana Choice Network


Premium $0 $45 $53

PCP $5 $5 $15






Rx Preferred







Market Service Area Bossier, Caddo, Webster Bienville, Claiborne, DeSoto, Red River, Sabine Statewide in Louisiana, Mississippi

LOUISIANA | SHREVEPORT - BOSSIER CITY MA/MAPD PLANS




Premium $0

PCP $0

Specialist $35








LOUISIANA | SHREVEPORT - BOSSIER CITY MA/MAPD PLANS


MARKET HIGHLIGHTS• Flagship $0 Plan Premium HMO Plans for the

Lafayette, Lake Charles, Alexandria Area with a NEW $0 Rx Deductible and Low PCP and Specialist Copays



• Local Marketing/Training Support to Facilitate External Agent Success. Convenient Retail Office Location Staffed by Market Leadership and Available to our External Agents

• Humana Guidance Center LITE offering Health Education, SilverSneakers Classes, Customer Service Kiosk, Social Activities and more—Open to Medicare Members and Community

• Improved Dental—HMOs Include Vision, Hearing, SilverSneakers, OTC Allowance, Go365 Member Rewards Program, Nurse Advice Line and a Web/Telemedicine Visit Benefit

• Strong Humana Brand Recognition Throughout the South West Central Market

• NEW $40 Part B Premium Giveback on the PPO MA Only Plan—Ideal for veterans Using VA for Drug Coverage and Other Beneficiaries with Credible Drug Coverage

NETWORK HIGHLIGHTS• Major Facilities Include but not Limited to:

Lake Charles Memorial, Lafayette General, Rapides General, Christus St. Patrick System, West Cal-Cam Hospital, Opelousas General

• Major Clinic participation include but not limited to: SWLA Community Care Clinic, Iberia Comprehensive Clinic, Teche Action Clinic, Cardiovascular Institute of the South


• All PPO Plans have National Network Reciprocity—Member may use any Humana PPO Choice Network Provider in Any State and Services will be Treated as IN-NETWORK

MARKET SERVICE AREAAcadia, Allen, Avoyelles, Beauregard, Calcasieu, Cameron, Concordia, Evangeline, Grant, Iberia, Jefferson Davis, La Salle, Lafayette, Natchitoches, Rapides, Saint Landry, Saint Martin, Saint Mary, Vermilion, Vernon, Winn

LOUISIANA SOUTH WEST CENTRAL

Plan Name Humana Gold Plus (HMO) Humana Gold Plus (HMO) HumanaChoice (PPO)

Plan Number H1951-049-001 H1951-049-002 H5216-064-000

Plan HighlightsFlagship $0 plan premium HMO for Beneficiaries Shopping for Value and Robust Core and Supplemental Benefits

Flagship $0 plan premium HMO for Beneficiaries Shopping for Value and Robust Core and Supplemental Benefits


Premium $0 $0 $45

PCP $10 $0 $5





Rx Deductible No Deductible No Deductible $400 tiers 4-5

Rx Preferred







Market Service Area Calcasieu, Cameron, Grant, Rapides Acadia, Iberia, Lafayette, Saint Landry, Saint Martin, Vermilion

Calcasieu, Cameron, La Salle, Lafayette, Saint Landry, Saint Martin, Saint Mary

LOUISIANA | SOUTH WEST CENTRAL MA/MAPD PLANS

Plan Name HumanaChoice (PPO) HumanaChoice (PPO)

Plan Number H5216-135-000 H5525-015-000

Plan Highlights



Premium $45 $45

PCP $5 $5

Specialist $45 $45

Referrals Required No No

Inpatient Hospital $225 per day Days 1-7 $225 per day Days 1-7

Max Out-of-Pocket $6,700 In Network $6,700 In Network

Rx Deductible $400 tiers 4-5 $400 tiers 4-5

Rx Preferred





Market Service Area Allen, Avoyelles, Beauregard, Evangeline, Jefferson Davis, Vernon Natchitoches, Winn

LOUISIANA | SOUTH WEST CENTRAL MA/MAPD PLANS


MARKET HIGHLIGHTS• Enhanced DSNP HMO with Loaded

Supplemental Benefits for QMB, QMB+, SLMB+ and FBDE Beneficiaries—Large Provider Network


• Local Marketing/Training Support to Facilitate External Agent Success with a Humana Sales Manager Located in the Area

• CORE & DSNP HMO plans include Dental, Vision, Hearing, SilverSneakers , OTC Allowance, Go365 Member Rewards Program, Nurse Advice Line and a Web/Telemedicine Visit Benefit

• Strong Humana Brand Recognition Throughout the Market

• Collaborative Physician Relationships and a Highly Engaged Humana Network Support Team

• Humana Owned Mail Order Pharmacy—$0 Rx Copay (90-Day Supply) Tier 1 & 2-All MAPD Plans

• NEW $40 Part B Premium Giveback PPO MA Only Plan—Ideal for veterans Using VA for Drug Coverage and Other Beneficiaries with Credible Drug Coverage



• Major Facilities Include but not Limited to: North Oaks, Cypress Point Surgical, LSU Lallie Kemp, St. Tammany Parish, Lakeview, Fairway Medical, Woman’s Hospital Baton Rouge

• Solid Compliment of Primary and Specialty Care Network Providers

• All PPO Plans have National Network Reciprocity—Member may use any Humana PPO Choice Network Provider in Any State and services will be treated as IN-NETWORK

MARKET SERVICE AREATangipahoa

LOUISIANA TANGIPAHOA PARISH

Plan Name Humana Gold Plus (HMO) HumanaChoice (Regional PPO) HumanaChoice (Regional PPO)

Plan Number H1951-024-000 R0110-002-000 R0110-003-000

Plan Highlights$59 plan premium HMO for Beneficiaries Shopping for network choice—NO referral requirement to see Specialists


$87 plan premium PPO plan—dental/vision OSBs—Statewide network with choice-Includes national network reciprocity

Premium $59 $53 $87

PCP $0 $15 $15



Inpatient Hospital $200 per day Days 1-7 at preferred facility $275 per day Days 1-7 $275 per day Days 1-7



Rx Preferred







Market Service Area Tangipahoa Parish Marketwide Statewide in Louisiana, Mississippi Statewide in Louisiana, Mississippi

LOUISIANA | TANGIPAHOA PARISH MA/MAPD PLANS




Premium $0

PCP $0

Specialist $35








LOUISIANA | TANGIPAHOA PARISH MA/MAPD PLANS

LOUISIANA

DUAL-ELIGIBLE SPECIAL NEEDS PLANS (DSNP)Humana’s DSNPs offer beneficiaries who qualify for both Medicare and Medicaid with $0 or low cost copays for many medical and pharmacy services, as well as rich supplemental benefits like dental coverage, eye exams and glasses, over-the-counter allowance, hearing aids, and more. DSNPs allow year-round enrollment. Eligible members must meet Medicaid requirements to enroll in these plans.

VALUE PLUS PLANSA Value Plus Plan is a Medicare Advantage plan offered by Humana with those eligible for both Medicare and Medicaid in mind, but since it’s a Medicare Advantage plan, it’s available to anyone with Medicare.

Dual-Eligible Medicare and Medicaid beneficiaries will receive $0 or low cost copays for many medical and pharmacy services, as well as rich supplemental benefits like dental coverage,

eye exams and glasses, over-the-counter allowance, hearing aids, and more. Dual eligibles may enroll in this plan year-round. Unlike a DSNP, if a beneficiary loses Medicaid status, they are not required to change health plans – they will keep this plan, but will lose their Medicaid benefits.

Value Plus Plans also appeal to Medicare beneficiaries who are familiar with Original Medicare benefits and cost sharing, who also desire pharmacy coverage and rich supplemental benefits.


LOUISIANA DSNP AND VALUE PLUS PLANS BENEFIT OVERVIEW

Plan Name Humana Gold Plus SNP-DE (HMO SNP)Plan Number H1951-041-000

Plan Highlights Dual-Eligible Special Needs HMO plan for QMB, QMB+, SLMB+ and FBDE with Loaded Supplemental Benefits

Dental $2,500 annually; $0 copayment covers: exams, x-rays, cleanings, fillings, crowns, extractions, dentures

Vision Annual exam and $300 credit every year for eyeglasses or contact lenses

Hearing $0 annual exams, fittings and TruHearing advanced level hearing aids plus 48 batteries

OTC Allowance OTC $275/Quarter for select health and wellness products

Transportation Up to 48 one-way trips to approved locations and fitness centers per year

Current Service AreaAcadia, Bossier, Caddo, Calcasieu, Caldwell, Cameron, Catahoula, East Carroll, Franklin, Grant, Iberia, Jackson, Lafayette, Lincoln, Madison, Morehouse, Ouachita, Rapides, Richland, Saint Landry, Saint Martin, Tangipahoa, Tensas, Union, Vermilion, Webster, West Carroll









Current Service Area Ascension, East Baton Rouge, East Feliciana, Iberville, Livingston, Pointe Coupee, Saint Helena, West Baton Rouge, West Feliciana









Current Service Area Assumption, Jefferson, Lafourche, Orleans, Plaquemines, Saint Charles, Saint James, St John The Baptist, Terrebonne









Current Service Area Saint Tammany, Washington


NEW

Plan Name Humana Value Plus (PPO)Plan Number H5525-037-000

Plan Highlights Lean medical and Rx benefits with rich supplemental benefits, designed with dual eligibles in mind yet available to all


Vision Annual exam and $200 credit every year for eyeglasses or contact lenses. OON coverage available. Some restrictions apply if benefits received Out-of-Network

Hearing In network: Annual exam and fitting plus $1,000 credit for hearing aids once every 3 years. Out of network: 25% coinsurance for annual exam and fitting plus $1,000 credit for hearing aids once every 3 years



Current Service Area Bienville, Claiborne, De Soto, Natchitoches, Red River, Sabine, Winn


NEW

Plan Name Humana Value Plus (PPO)Plan Number H5216-161-000

Plan Highlights Lean medical and Rx benefits with rich supplemental benefits, designed with dual eligibles in mind yet available to all


Vision Annual exam and $200 credit every year for eyeglasses or contact lenses. OON coverage available. Some restrictions apply if benefits received Out-of-Network

Hearing In network: Annual exam and fitting plus $1,000 credit for hearing aids once every 3 years. Out of network: 25% coinsurance for annual exam and fitting plus $1,000 credit for hearing aids once every 3 years



Current Service Area Allen, Avoyelles, Beauregard, Evangeline, Jefferson Davis, La Salle, Saint Bernard, Saint Mary, Vernon

Plan Name Humana Preferred Rx Plan (PDP) Humana Walmart Rx Plan (PDP)

Plan Number S5884-108-000 S5884-167-000

Plan HighlightsPairs well for members with Extra Help (LIS). Tier 1 & Tier 2 mail-order copays are $0 at Humana Pharmacy for 90-day supply.

Retail copays as low as $1. Tier 1 mail-order copays are as low as $0 at Humana Pharmacy for 90-day supply.

Premium TBD TBD

Rx Deductible $415 all tiers $415 tiers 3-5

Preferred Retail 30-day Supply No Coverage $1/$4/20%/35%/25%

Standard Retail 30-day Supply $0/$1/25%/36%/25% $10/$20/25%/50%/25%

Preferred Mail 90-day Supply $0 copay for tiers 1 & 2 $0 copay for tiers 1 & 2

Market Service Area Louisiana Statewide Louisiana Statewide

LOUISIANA PDP PLANS

LOCAL SUPPORT

LOUISIANA

Local Market Office(504) 667-4366

Tiffany McGuireBroker Relationship Manager (504) [email protected]

Gary ChinBroker Relationship Executive(855) [email protected]

medicare advantage plans louisiana...external agent success-metairie retail office location staffed...

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