The HumanaOne Colorado Individual/Family plans let you customize your policy based on how you plan to use it. The basic plans have a variety of medical deductibles ($500, $1000, $2500, $5000) with a separate $500 deductible for prescriptions before they are covered with a copay. Sick doctors visits accumulate toward the medical deductible on these plans, but you have the choice of adding 4 doctors visits per year per person covered with a $25 copay before the medical deductible. You also have the option of having a $0 deductible on prescriptions, so they will be covered with a copay right away. These plans all have excellent preventive care covered before the deductible.Compare Your Options
Here is a quick comparison between a traditional PPO plan and an HSA qualified high-deductible health plan. This is a general overview of plan features. Please refer to the Colorado plan description for actual terms and conditions. Limitations and exclusions apply.
| HumanaOne Individual Health Plan | HumanaOne HSA Qualified Plan | |
|---|---|---|
| Plan Design | Preferred Provider Organization (PPO) | Preferred Provider Organization (PPO). The plan is HSA qualified meaning that you can open an HSA with any bank you choose, HumanaOne works with Chase as an administrator. |
| Deductible Options | Deductibles are calendar year:
These deductibles are for in-network providers, there is a separate deductible for nonparticipating providers |
Deductibles are calendar year:
You can use tax-free HSA funds to meet your deductible. Deductibles listed are for in-network providers; there is a separate deductible for nonparticipating providers. |
| For family coverage, is there a separate deductible for each individual | Yes, each family member has a separate deductible. However, the family deductible is two or three times the individual deductible – so if four or more family members are covered, only two or three may have to meet the separate individual deductible to satisfy the family deductible, too. | No, the family deductible applies to all covered family members, so one person’s covered expenses could satisfy the deductible for the entire family. |
| Coverage after the deductible | The plan pays coinsurance as shown on the Summary of Benefits. The coinsurance percentage varies depending on the service you receive. | The plan pays coinsurance as shown on the Summary of Benefits. You can use HSA funds to pay your share, if any. Humana offers two coinsurance options: an 80/60 plan and a 100/70 plan. With the 100/70 plan, the plan pays 100% of your costs for common services like doctor’s office visits when you use participating providers. |
| Are there copayments? | Yes, some services require a copay. Also, you may have the opportunity to purchase the office visit copay optional benefit; with this option, you pay a copayment for certain kinds of doctor’s office visits (illness or injury, not preventive care), and then your plan covers the rest of the cost. |
No, the plan doesn’t require copayments. |
| Do copays help reduce the deductible? | No, medical and prescription drug copayments do not apply to your deductible or out-of-pocket maximum. | N/A |
| Is there a maximum out-of-pocket per year? | Yes, the plan has separate out-of-pocket expense limits for participating and nonparticipating providers. Once you reach the limit for participating providers, the plan pays 100% for covered services. However, copays and some other costs don’t apply to the limit. | Yes, the plan has separate out-of-pocket expense limits for participating and nonparticipating providers. With the 100/70 coinsurance plan, the participating provider limit is the same as the deductible – so once you reach your deductible, the plan pays 100% for covered services. |
| Are prescription drugs covered? | You pay the entire bill for prescriptions until you meet your Rx deductible. However, as a Humana member you get a discounted price when you use participating pharmacies. Once you meet the deductible, you pay only a copayment for covered drugs. Drugs are assigned to one of four levels, and the copayment varies by level. You may have the option to purchase a zero deductible prescription drug benefit. |
When you fill prescriptions for drugs on Humana’s High Deductible Health Plan Drug List, the cost applies to your medical deductible. As a Humana member, you pay a discounted price when you use participating pharmacies. Then, once you meet the deductible with any combination of medical and prescription drug costs, your plan pays coinsurance as specified in your plan. With Humana’s 100/70 coinsurance plan, the plan pays 100% for covered drugs, and you pay nothing. |
| Are dental services covered? | No, unless the service is related to an injury. A separate dental plan is available as an optional benefit. | Not available with HSA qualified plans in Colorado |
| Are vision expenses covered? | No, but a vision discount program may be available if you choose the optional dental coverage. | Not available with HSA qualified plans in Colorado. |
| What is the maximum that can be contributed to the health savings account each year? | N/A | Your maximum yearly contribution is based on your plan deductible, coverage level, age, and other factors. Unless you’re age 55 or older, HSA contributions can’t exceed the plan deductible or the IRS maximum, whichever is lower. |
| Are there fees for the health savings account? | N/A | Yes, since the account is in your name – just like a personal checking or savings account – you’re responsible for the fees your bank charges (if any). |
More Information on HumanaOne HSA Qualified Plans
More detailed information about the HumanaOne HSA qualified plan in Colorado, you can view the Colorado plan description form or the brochure. You can compare the rates to other HSA qualified plans in Colorado using our instant quotes. A comparison of the individual plan benefits and the HSA qualified plan benefits can be seen above.
Individual Health Plan Optional Benefit Descriptions
With a Colorado HumanaOne Individual Health Plan, you have a choice of adding optional benefits such as:
- Dental benefit option (1)- great dental benefits keep your mouth and teeth healthy. Although the dental benefit isn't included in the online quote, you can find out what it will cost if you call or email us.
- For preventive Services plan pays 100% with no deductible.
- - Oral Examinations
- - Routine Cleanings
- - X-rays
- - Sealants
- - Topical fluoride treatments
- For basic services, the plan pays 50% after the deductible
- - Emergency exams and palliative care for pain relief
- - Thumb sucking and harmful habit appliances
- - Space maintainers
- - Amalgam, composite fillings
- - Oral surgery
- - Routine extractions
- - Non-cast stainless steel crowns
- - Partial or complete denture repairs/adjustments
- For teeth whitening services, the plan pays 50% after the deductible
- - $200 lifetime maximum
- For major services, the plan pays 50% after deductible
- - Endodontics (root canals)
- - Periodontics
- - Crowns
- - Inlays and onlays
- - Partial or complete dentures
- - Denture relines / rebases
- - Removeable or fixed bridgework
- Orthodontia discount
- - Members can receive up to a 20% discount if they visit a dentist from the Humana Dental PPO network and ask for the discount.
- Annual Deductible
- - $50 Individual
- - $150 Family
- Annual maximum benefit
- - $1,000
- You can visit any dentist you like, but you can save up to 30% in out-of-pocket costs when you visit one of more than 70,000 Humana dentists in the PPO network.
- For preventive Services plan pays 100% with no deductible.
- $0 deductible prescription drug option (2)(4)- you won't need to meet the separate $500 deductible before getting the prescription copays covered in your plan
- Office Visit Copayment Option (2)(3)- the plan will pay 100% of sick doctor visits (also includes office diagnostic tests, labs and x-rays paid at 100% up to $100 per calendar year). The plan will pay 100% after you meet the $25 copay for primary care physicians and a $40 copay for specialists. . This benefit applies only when you see a participating primary care doctor or specialist because of illness or injury. It doesn't apply for preventive care services or nonparticipating providers. The office visit copayment option is limited to four visits per year. If you exceed the four visits in one calendar year, the doctors visits are subject to your deductible and coinsurance.
- Maternity Benefit Option (2) - provides benefits for maternity and routine newborn care (a 1 year waiting period applies in Colorado). This benefit has a separate $500 deductible, then pays up to 60% with no co-insurance maximum on maternity. Although you won't see this option in your online quote, it can be added as part of your product selection when you call to apply . Please review the Colorado plan description form or a brochure for more details. Insurance Shoppers can give you the extra cost for maternity when you call or email us.
- HumanaOne Term Life Insurance - affordable financial protection with coverage amounts from $25,000 to beyond $1 million and premiums are level for 10, 15, or 20 years guaranteed to age 95.
- Primary/spouse life insurance option - provides $20,000 of life insurance coverage for the primary applicant and/or the applicant's spouse. This coverage terminates when the health plan terminates.
More detailed HumanaOne plan information can be seen by downloading a Colorado Plan Description Form, or a Brochure. You can compare the rates of HumanaOne plans to other plans in Colorado using our instant quotes. You can compare how the traditional individual/family plans and HSA qualified plans provide coverage above.
To be covered, services must be medically necessary and specified as covered. Please see your policy for more information on medical necessity and other specific plan benefits.
(1) This is not a complete disclosure of plan qualifications and limitations. Waiting periods apply: six months on basic service and teeth whitening, 12 months on major services. Please review the specific Dental limitations & exclusions before applying for coverage.
(2) Copayments do not apply to the deductible or out-of-pocket maximum. The medical out-of-pocket maximum. The medical out-of-pocket maximum does not apply to transplant services from nonparticipating providers, prescription drugs, mental health services or maternity, if the optional maternity benefit is selected.
(3) This benefit does not cover MRI, CAT, EEG, EKG, ECG, cardiac catheterization or pulmonary function studies. Primary care physicians include family practitioner, general practitioner, pediatrician or internist; specialist contains any other participation physician. Please contact Humana Customer Service for details.
(4) If a nonparticipating pharmacy is used you must pay 100% of the actual charges and file a claim with Humana for reimbursement.
**Any descriptions of coverage on this page may not be current and should not be taken as a description of coverage. Any persons seeking to get a full description of coverage should view Colorado plan description forms and/or brochures for the plan they are interested in.
