Humana’s Specialized Care Partners are described for Medicare members, and employers should confirm what applies to their group.
Humana lists outside organizations it has teamed up with to serve eligible Medicare members. The page speaks to members, not employers, and Humana is exiting employer group commercial medical.
What the program is and what members do.
What the program is
Humana says specialized care partners are organizations it has teamed up with to meet the unique needs of eligible Medicare members. The page lists the partners by the area of care they cover.
What areas are listed
The carrier lists comprehensive care management, heart health support, behavioral and mental health support, chronic kidney care and in-home urgent medical care. It also lists dementia screening, diagnosis and care management, cancer support, serious illness support and diabetes specialist support.
How members connect
Humana tells members to search the list to learn about the partnerships. Connection methods vary by partner and may include a nurse line, virtual visits or in-home services.
Eligibility, funding and plan design.
Who can use it
The page refers to eligible Medicare members and eligible Medicare Advantage members, with condition based criteria that vary by partner. It does not describe employer group commercial medical members. Employers should confirm with Humana for their group.
How it is funded or sold
Costs vary by partner. Some services are listed at no additional cost, while others are described as care typically covered by the Medicare Advantage plan, with plan documents holding the details. Humana does not describe an employer fee.
Where it fits in plan design
For an employer, the useful part is as a reference for retirees on Humana Medicare coverage. For commercial medical, the page gives no basis to include it in plan design, and Humana is exiting that line.
What to settle before relying on it.
Which of these partners serve our population?
The page speaks to Medicare members. We would ask Humana whether any partner serves commercial members, and if so which one and until when.
How are the partners paid and supervised?
We would ask whether the partners are paid by Humana or by the plan, and what oversight Humana applies to the quality of their work.
How would a member be matched to a partner?
We would ask whether members self refer or Humana reaches out, and what the employer can say in member communications.
Common questions about this program.
What is a specialized care partner?
Humana describes them as organizations it has teamed up with to meet the unique needs of eligible Medicare members.
Do they cost extra?
It depends on the partner. Humana lists some as at no additional cost and others as covered by the Medicare Advantage plan.
Does this apply to employer group medical?
The page speaks to Medicare members. Humana is exiting employer group commercial medical, so confirm with Humana.
Where these details come from.
This page summarizes what Humana publishes. Programs change, so confirm current details with the carrier before relying on them.
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