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The
HumanaOne Autograph health plans offer a selection
of cost sharing features, plan deductibles, and optional benefits,
so it can be customized to your needs, allowing you to choose
the level of protection you want at a cost that fits your
budget.
Please
view the Autograph Plan Brochures to see detailed information
including Plan Provisions, Limits & Exclusions, and State
Variations:
Share
80 Plus Rx/Copay 
- Share
70 Plus Rx
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Plans
at a Glance:
There
are two HumanaOne Autograph non-HSA plans: the Autograph
Share 80 Plus Rx/Copay and the Autograph Share 70
Plus Rx. The main distinctions between the two
plans are the lifetime maximum ($5 mil/$2 mil), the coinsurance
(80%/70%), and the office visit copay ($35/none).
|
|
|
Plan
pays for services at
PARTICIPATING providers
|
Plan
pays for services at
NON-PARTICIPATING providers
|
| Annual
Deductible |
| · |
Annual
amount (does not apply to maximum out-of-pocket
expense) |
|
|
|
Maximum
Out-of-Pocket Expense
(after deductible) |
| · |
Individual
(must be satisfied by each covered person) |
|
|
Individual
$2,000
|
Family
$4,000
|
|
|
Individual
$8,000
|
Family
$16,000
|
|
Preventive
Care |
| · |
Well-child
care (including immunizations) (birth to age 13) |
| · |
Routine
annual PSA and digital rectal exam |
| · |
Routine
annual Mammograms |
| · |
Routine
Annual physical exam (age 13 and older) |
| · |
Routine
immunizations
(age 13 to 18) |
| · |
Routine
lab, pathology and X-ray |
|
|
|
Physician Services |
| · |
Office
visits: Primary care |
| · |
Office
Visits: Specialty care
(limited to 6 combined Primary and Specialty care
visits/calendar year)
(includes allergy injections) |
| · |
Diagnostic
lab, X-ray and allergy testing |
| · |
Outpatient
services (includes surgery) |
|
|
$35
copayment for 6 visits, then you pay 20%
coinsurance after deductible |
|
$50
copayment for 6 visits, then you pay 20%
coinsurance after deductible |
|
First
$200/yr covered 100%, then you pay 20%
coinsurance after deductible |
|
You
pay 20% coinsurance after deductible |
|
|
You
pay 40% coinsurance after deductible |
|
You
pay 40% coinsurance after deductible |
|
You
pay 40% coinsurance after deductible |
|
You
pay 40% coinsurance after deductible |
|
Hospital
Services |
| · |
Outpatient
surgery - facility |
| · |
Emergency
room (includes physician visits) |
|
|
You
pay 20% coinsurance after deductible |
|
You
pay 20% coinsurance after $75 copayment per
visit and deductible (copayment waived if admitted) |
|
|
You
pay 40% coinsurance after deductible |
|
You
pay 40% coinsurance after $75 copayment per
visit and deductible (copayment waived if admitted) |
|
Prescription Drugs |
| · |
Prescription
drug deductible (Covered prescription drugs are
assigned to one of four different levels with corresponding
copayment amounts.) |
| · |
Benefit
for each prescription or refill (up to 30-day supply) |
| - |
Level
One - lowest copayment for lowest cost generic
and brand-name drugs |
| - |
Level
Two - higher copayment for higher cost generic
and brand-name drugs |
| - |
Level
Three - higher copayment than Level Two for
higher cost, mostly brand-name drugs that may have
generic or therapeutic equivalents in Levels One
or Two |
| - |
Level
Four - highest copayment for high-technology
drugs (certain brand-name drugs, biotechnology drugs
and self-administered injectable medications |
| · |
Mail
Order (90 day supply) |
|
|
$1,000
prescription drug deductible per individual |
|
$15
co-pay, not subject to prescription deductible |
|
$35
co-pay after prescription drug deductible |
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$55
co-pay after prescription drug deductible |
|
25%
co-pay up to $2,500 out of pocket maximum per year |
|
100%
covered after three times the retail copayment |
|
|
$1,000
prescription drug deductible per individual |
|
$15
co-pay, not subject to prescription deductible |
|
$35
co-pay after prescription drug deductible |
|
$55
co-pay after prescription drug deductible |
|
25%
co-pay up to $2,500 out of pocket maximum per year |
|
70%
covered after three times the retail copayment |
|
Other Medical Services |
| · |
Skilled
nursing facility (up to 30 days per calendar year) |
| · |
Home
health care (up to 60 days per calendar year) |
| · |
Durable
medical equipment |
| · |
Complications
of pregnancy and sick baby services |
| · |
Transplant
services (organ) ** |
|
|
You
pay 20% coinsurance after deductible |
** when services are performed at a National Transplant
Network provider
|
|
You
pay 40% coinsurance after deductible |
** subject to out of pocket maximum of $35,000 per covered
transplant per year
|
| Mental
Health (mental disorders,
alcohol and chemical dependence) |
|
Inpatient
and Outpatient care (Combined $2,500 per calendar
year maximum. Outpatient care not to exceed
$500 of the $2,500 calendar year maximum.) |
|
You
pay 50% coinsurance
after
deductible
|
You
pay 50% coinsurance
after
deductible
|
Optional
Benefits |
| · |
Lifetime
Maximum Benefit |
| · |
$500
Supplemental Accident Benefit |
| · |
$1000
Supplemental Accident Benefit |
| · |
$500
Prescription Drug Benefit |
|
|
$8
million per covered person |
|
First
$500 per accident covered at 100%, then base plan
benefits apply |
|
First
$1000 per accident covered at 100%, then base plan
benefits apply |
|
Under
this option, $500 deductible is required to be met
before plan benefits are payable |
|
|
$8
million per covered person |
|
First
$500 per accident covered at 100%, then base plan
benefits apply |
|
First
$1000 per accident covered at 100%, then base plan
benefits apply |
|
Under
this option, $500 deductible is required to be met
before plan benefits are payable |
|
|
Lifetime
Maximum
|
$5,000,000
|
|
|
|
Plan
pays for services at
PARTICIPATING providers
|
Plan
pays for services at
NON-PARTICIPATING providers
|
| Annual
Deductible |
| · |
Annual
amount (does not apply to maximum out-of-pocket
expense) |
|
|
|
Maximum
Out-of-Pocket Expense
(after deductible) |
| · |
Individual
(must be satisfied by each covered person) |
|
|
Individual
$3,000
|
Family
$10,000
|
|
|
Individual
$6,000
|
Family
$20,000
|
|
Preventive
Care |
| · |
Well-child
care (including immunizations) (birth to age 13) |
| · |
Routine
annual PSA and digital rectal exam |
| · |
Routine
annual Mammograms |
| · |
Routine
Annual physical exam (age 13 and older) |
| · |
Routine
immunizations
(age 13 to 18) |
| · |
Routine
lab, pathology and X-ray |
|
|
|
Physician Services |
| · |
Office
visits: Primary care |
| · |
Office
Visits: Specialty care
(limited to 6 combined Primary and Specialty care
visits/calendar year)
(includes allergy injections) |
| · |
Diagnostic
lab, X-ray and allergy testing |
| · |
Outpatient
services (includes surgery) |
|
|
$35
copayment for 6 visits, then you pay 30%
coinsurance after deductible |
|
$50
copayment for 6 visits, then you pay 30%
coinsurance after deductible |
|
First
$200/yr covered 100%, then you pay 30%
coinsurance after deductible |
|
You
pay 30% coinsurance after deductible |
|
|
You
pay 50% coinsurance after deductible |
|
You
pay 50% coinsurance after deductible |
|
You
pay 50% coinsurance after deductible |
|
You
pay 50% coinsurance after deductible |
|
Hospital
Services |
| · |
Outpatient
surgery - facility |
| · |
Emergency
room (includes physician visits) |
|
|
You
pay 30% coinsurance after deductible |
|
You
pay 30% coinsurance after $125 copayment
per visit and deductible (copayment waived if admitted) |
|
|
You
pay 50% coinsurance after deductible |
|
You
pay 50% coinsurance after $125 copayment
per visit and deductible (copayment waived if admitted) |
|
Prescription Drugs |
| · |
Prescription
drug deductible (Covered prescription drugs are
assigned to one of four different levels with corresponding
copayment amounts.) |
| · |
Benefit
for each prescription or refill (up to 30-day supply) |
| - |
Level
One - lowest copayment for lowest cost generic
and brand-name drugs |
| - |
Level
Two - higher copayment for higher cost generic
and brand-name drugs |
| - |
Level
Three - higher copayment than Level Two for
higher cost, mostly brand-name drugs that may have
generic or therapeutic equivalents in Levels One
or Two |
| - |
Level
Four - highest copayment for high-technology
drugs (certain brand-name drugs, biotechnology drugs
and self-administered injectable medications |
| · |
Mail
Order (90 day supply) |
|
|
$1,000
prescription drug deductible per individual |
|
$15
co-pay, not subject to prescription deductible |
|
$35
co-pay after prescription drug deductible |
|
$55
co-pay after prescription drug deductible |
|
25%
co-pay up to $2,500 out of pocket maximum per year |
|
100%
covered after three times the retail copayment |
|
|
$1,000
prescription drug deductible per individual |
|
$15
co-pay, not subject to prescription deductible |
|
$35
co-pay after prescription drug deductible |
|
$55
co-pay after prescription drug deductible |
|
25%
co-pay up to $2,500 out of pocket maximum per year |
|
70%
covered after three times the retail copayment |
|
Other Medical Services |
| · |
Skilled
nursing facility (up to 30 days per calendar year) |
| · |
Home
health care (up to 60 days per calendar year) |
| · |
Durable
medical equipment |
| · |
Complications
of pregnancy and sick baby services |
| · |
Transplant
services (organ) ** |
|
|
You
pay 30% coinsurance after deductible |
** when services are performed at a National Transplant
Network provider
|
|
You
pay 50% coinsurance after deductible |
** subject to out of pocket maximum of $35,000 per covered
transplant per year
|
| Mental
Health (mental disorders,
alcohol and chemical dependence) |
|
Inpatient
and Outpatient care (Combined $2,500 per calendar
year maximum. Outpatient care not to exceed
$500 of the $2,500 calendar year maximum.) |
|
You
pay 50% coinsurance
after
deductible
|
You
pay 50% coinsurance
after
deductible
|
Optional
Benefits |
| · |
Lifetime
Maximum Benefit |
| · |
$500
Supplemental Accident Benefit |
| · |
$1000
Supplemental Accident Benefit |
| · |
$500
Prescription Drug Benefit |
|
|
$8
million per covered person |
|
First
$500 per accident covered at 100%, then base plan
benefits apply |
|
First
$1000 per accident covered at 100%, then base plan
benefits apply |
|
|
$8
million per covered person |
|
First
$500 per accident covered at 100%, then base plan
benefits apply |
|
First
$1000 per accident covered at 100%, then base plan
benefits apply |
|
|
Lifetime
Maximum
|
$2,000,000
|
|
Note:
These charts contain a general summary of benefits, exclusions,
and limitations. Please refer to the Autograph HSA Plan
brochures for the actual terms and conditions that apply:
Share
80 Plus Rx/Copay
- Share
70 Plus Rx
|
|
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Coverage
Synopsis:
Share
80 Plus Rx/Copay
The
Share 80 Plus Rx/Copay pays 100% of your primary care physician
office visits after a $35 co-pay, up to six per year.
It then covers 80% of your office visit costs after your deductible
is met. The plan also pays for 100% of your prescription
drugs after your $1,000 prescription drug deductible is met,
and your co-pay. For non-participating providers the plan
pays 60% of the costs after your non-participating provider
deductible is met. The office visit co-payment benefit
does not apply to preventive care services.
For
preventive care the plan pays 80% before your deductible.
Some preventive care is not covered with Non-Participating providers
(routine annual physical exam (age 13 and older), routine immunizations
(age 13 and older), routine pap smear, and routine lab, pathology
and X-ray).
Lifetime
maximum is $5 million, and can be increased to $8 million with
the optional lifetime maximum benefit.
With
this plan you can add an option to have a $500 prescription
deductible. Cost for this benefit is based on your individual
characteristics, i.e. age, gender, etc.
Share
70 Plus Rx
The
Share 70 Plus pays 70% of your medical expenses after your deductible.
The plan also pays for 100% of your prescription drugs after
your $1,000 prescription drug deductible is met, and your co-pay.
The plan also pays for expenses up to 50% of the total cost
at Non-participating providers after the non-participating provider
deductible has been met.
Lifetime
maximum is $2 million, and can be increased to $5 million with
the optional lifetime maximum benefit.
Preventive
care is covered 70% with Participating providers before your
deductible. Some preventive care is not covered with Non-Participating
providers (such as: Routine annual physical exam (age 13 and
older), routine immunizations (age 13 and older), routine pap
smear, and routine lab, pathology and X-ray).
With Both
Autograph Non-HSA Plans you can enjoy these extra benefits:
- Special
Discounts
- Eye
care and vision services - Save up to 45 percent
- Over-the
counter and prescription medication - Save up to 25 percent
- Chiropractic,
acupuncture, and massage therapy - Save up to 30 percent
- Health-related
products and services, including skin care, nutrition supplements,
and vitamins - Save up to 20 percent
- Access
to MyHumana for helpful health plan
information, medical information, cost savings tips, and
tools
- The convenience
of a one-stop destination for life, dental, and individual health
insurance
Optional
Benefits:
Dental
Coverage
You
can choose any dentist, but you can save up to 30 percent on
out-of-pocket costs when you visit one of the more than 75,000
dentist locations in the PPO network. The annual deductible
is $50 for an individual and $150 for a family.
The
plan pays 100% of all preventative services, then 50% after
the deductible for basic, major and teeth whitening services,
up to an annual maximum of $1,000. You can also receive
up to a 20% discount on orthodontia if you visit an orthodontist
from the HumanaDental PPO network and ask for the discount.
Cost
for this benefit is based on your individual characteristics,
i.e. age, gender, etc and rates start around $30 per month in
addition to the base premium. When you run a quote with
us you will see options with and without this optional benefit.
Lifetime
maximum
For
$3 more per month you can extend your coverage and get the added
protection you need with the $8 million lifetime maximum.
Supplemental
accident benefits
If
you have a minor accident that doesn't cost a lot, this benefit
will cover you right away--up to $500 or $1000 per incident,
before your deductible is required. Anything over the
initial benefit will go towards your deductible and base plan
benefits apply. The cost for an individual for this benefit
is an additional $8.12 per month. Family rates vary by
number of members and ages.
Rate
Information:
Rates for
all three Humana HSA plans
are available on our instant quote
page.
Rates
vary based on age, zip code of residence, and other factors.
Humana are very competitive,
particularly for their higher deductible plans. When running
your quote, please note that rates are often lower when placing
the younger spouse as primary insured.
The
premium can be paid via monthly, quarterly, semi-annual, or annual
billing, or a monthly bank draft. There is a $10 fee for
quarterly and monthly billing. The bank draft will occur
on the premium due date each month. The initial premium
can be paid with a check or credit card.
PPO
Networks:
Humana
utilizes the ChoiceCare network.
Insureds can use Humana
doctors throughout the United States. Having access to the
PPO network can mean substantial discounts in what you pay for
your health care, even before you meet your deductible.
View the complete ChoiceCare
PPO Network (check the HumanaOne and Member
radio buttons, enter your zip code and click Go. Then select
the Humana/ChoiceCare PPO Network and click Go).
Please
note that the Humana PPO network has an inadequate number of providers
in the following counties in Colorado: Dolores, Hinsdale, Mineral,
Ouray, Saguache, San Juan, San Miguel.
The
Humana plans are portable,
so you can move throughout the country without having to change
insurance companies, and still have access to their large network.
Underwriting:
The
Humana Health Insurance underwriting process is extremely fast.
Someone from their underwriting department will call you to do
a telephone interview. Often times you can be given a conditional
approval during the telephone interview, if no medical records
are needed. If medical records are needed, Humana issues
a decision within 48 hours after receipt of records.
One
important aspect of Humana's underwriting process is that it is
done up-front only, when the application is submitted. Many
insurance companies will underwrite again when a claim is submitted,
and may retroactively place a waiver on a plan if a claim occurs
in the first 12 months and they determine that it was a pre-existing
condition. With Humana, if you do not receive a rate up
or rider when you receive the policy, they cover the condition
based on the plans benefits, and do not re-underwrite.
By the way,
Humana has a history of paying claims quickly and currently pays
92% of all claims in 8 days or less.
Effective
dates:
If
you currently have or have recently had coverage, you can request
an effective date any time between the day you apply and 45 days
later. If an underwriter gives you conditional approval,
your health insurance coverage can go into effect immediately.
If you have not had major medical health insurance within the
past two months, you will have the choice of an effective date
of 30 to 45 days after the application submission date.
If
you are ready to apply and have urgent question, please use our
contact form, or call our office
at 866-749-2045 and see if Carol can put you through to one of
our advisors. For more information on how to choose a plan
and apply for coverage, see our Consumer's
Guide page.
About
Humana:
Humana
Inc., headquartered in Louisville, Kentucky, is one of the nation's
largest publicly traded health benefits companies, with approximately
6.6 million medical members located primarily in 18 states and
Puerto Rico. Humana offers coordinated health insurance
coverage and related services - through traditional and Internet-based
plans - to employer groups, government-sponsored plans, and individuals.
Humana
Insurance Company has been assigned a rating of "A-"
(Excellent) from the A.M.
Best Company, an independent insurance rating organization.
ColoHealth
is an independent authorized Humana agent in Colorado.
"You
were able to answer all of my questions one on one, personalized
to my specific situation."
This
was the first time I ever used an independent broker and
I’m glad I did because I was able to shop for all
the available carriers in one place. Plus, your
website is pretty good about providing the quotes and
the sort functions are wonderful. Your service stands
out from the rest in that you were able to answer all
of my questions one on one, personalized to my specific
situation. Other agents I’ve used weren’t
nearly as knowledgeable and were transparent as sales
people with only one goal which was to get me to sign
up regardless of my concerns and questions.
| |
Julie
Jee
Greenwood Village, CO |
Read
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