There is no such thing as “the” Humana Medicare Advantage plan. For the 2026 plan year, CMS’s own landscape file lists 887 separate Humana plan segments, each with its own counties, its own premium, its own copays, and its own out-of-pocket ceiling. A Humana plan in Broward County, Florida and a Humana plan two states away can differ by thousands of dollars a year.
That is why Humana will not quote you a price without a ZIP code, and why every “Humana costs $X” number you see online is close to meaningless. What follows is built from CMS’s per-plan 2026 data and from Humana’s own published plan documents, so you can see the actual spread and then check your own county against it.
What Is Humana Medicare Advantage
Humana Medicare Advantage is Humana’s version of Part C, a private plan that replaces Original Medicare as your coverage. Medicare pays Humana a fixed amount per member per month, and Humana takes on your Part A and Part B benefits plus, on most plans, Part D drug coverage and extras Original Medicare never had. If the parts of Medicare are still fuzzy, start there.
Humana is the second largest Medicare Advantage insurer in the country. KFF’s 2026 analysis puts Humana at 20% of national enrollment, roughly 7 million people, up from 17% in 2025. That was the largest single-year gain of any insurer, about 1.3 million additional enrollees, at the same time UnitedHealth Group shed roughly 647,000. Humana and UnitedHealthcare together now cover close to half of everyone in Medicare Advantage.
The brand names matter, because they tell you the plan type before you read anything else. In CMS’s 2026 file, 178 Humana plan segments carry the Humana Gold Plus name, and those are HMO and HMO-POS plans. 180 carry HumanaChoice, which are PPOs. Humana USAA Honor plans (68 segments) are built for veterans and military families, Giveback in a plan name means the plan reduces your Part B premium, and SNP-DE or Dual Select means a plan for people who also have Medicaid.
How Humana’s Plans Work
Humana sells nearly every Medicare Advantage structure CMS allows. Across the 887 plan segments in the 2026 landscape file, the breakdown is 360 PPOs, 216 HMOs, 37 HMO-POS, 29 regional PPOs, and 11 private fee-for-service plans, plus 234 special needs plans (147 dual-eligible, 74 chronic condition, 13 institutional).
The structure decides how much freedom you get.
Gold Plus HMO plans lock you to a network and a referral. The 2026 Summary of Benefits for Humana Gold Plus Giveback H1036-305 (HMO), sold in Broward, Miami-Dade, and Palm Beach counties, states that your primary care provider “will work with you to coordinate the care you need with specialists,” which is the referral requirement in plain words.
HumanaChoice PPO plans do not require referrals. The 2026 HumanaChoice Florida H5216-068 (PPO) document, covering the same three counties, says outright that you do not need a referral to receive covered services from plan providers. You can also go out of network, at higher cost sharing.
Both documents carry the same warning about prior authorization: the plan requires it for certain items and services, with the list posted at Humana.com/PAL. This is not a Humana quirk. KFF found that in 2026, 99% of Medicare Advantage enrollees are in plans that require prior authorization for at least some services, including 97% for acute inpatient stays, 95% for skilled nursing, and 94% for Part B drugs. Only 6% of plans apply it to preventive services. If a request gets denied, the Medicare appeal process is your remedy, and understanding how prior authorization works before you need surgery is worth an hour of your time.
Service areas are county-level. A Humana plan sold in your county may not exist one county over, which is also why Humana’s supplemental benefits, including the routine vision and dental allowances discussed on our Humana vision insurance and Humana dental plans pages, vary plan by plan rather than following a single national grid.
What It Costs
Every figure below is from the 2026 plan year. The plan-level range comes from CMS’s CY2026 landscape file. The two named plans come from Humana’s own Summary of Benefits documents and were cross-checked against the same CMS file, where the premiums, out-of-pocket maximums, and drug deductibles match exactly.
| 2026 cost item | Humana range or figure | Notes |
|---|---|---|
| Monthly plan premium, individual plans | $0 to $189 | 71% of 653 individual plans are $0; median $0 |
| Monthly plan premium, special needs plans | $0 to $138 | 56% are $0 |
| Medicare Part B premium (you always pay this) | $202.90 | Standard 2026 rate, up from $185.00 in 2025 |
| In-network out-of-pocket maximum | $375 to $9,250 | Median $5,900 on individual plans; $9,250 is the CMS ceiling |
| Part D drug deductible | $0 to $615 | 472 of 798 Humana drug plans sit at the $615 legal maximum |
| Humana Gold Plus Giveback H1036-305 (HMO), South Florida | $0 premium, $3,850 in-network cap | $0 primary care copay, $30 specialist, $0 drug deductible, $250 per day inpatient days 1 to 7 |
| HumanaChoice Florida H5216-068 (PPO), South Florida | $0 premium, $3,900 in-network cap | $0 primary care copay, $35 specialist, $6,100 combined in and out-of-network cap |
A few things that table hides.
The $0 premium is real but partial. You still owe Medicare $202.90 a month for Part B in 2026, plus the $283 Part B deductible if the plan does not absorb it. Humana’s own cost explainer makes the same point, noting the 2026 Part B premium and quoting the CMS national average Medicare Advantage premium of about $14 a month, while publishing no premium for any actual Humana plan.
Some plans hand part of the Part B premium back. The Gold Plus Giveback plan above states it will reduce your monthly Part B premium by up to $148, capped at the Part B premium itself. Humana adds that the Social Security Administration can take several months to process it.
Drug deductibles are where Humana is least generous. Of the 798 Humana plans with Part D coverage in 2026, 472 sit at $615, which is the maximum any Part D plan is legally allowed to charge. Only 73 have no deductible at all. If your prescriptions are expensive, read the tier structure before the premium, and check our Medicare Part D cost breakdown for how the 2026 $2,100 out-of-pocket cap changes the math.
Star ratings differ by plan too. Humana’s individual plans average 3.71 stars in the 2026 file, below UnitedHealthcare’s 3.99 and Aetna’s 3.98 on the same measure.
Who It’s Good For and Who Should Skip It
A good fit if you want a hard ceiling on spending and a low monthly bill. A $0 premium plan with a $3,850 in-network maximum caps your medical exposure at a number you can plan around, which Original Medicare alone does not do.
A good fit if you use routine dental, vision, and hearing. KFF found more than 99% of individual Medicare Advantage plans offer vision, 98% dental, 95% hearing, and 91% fitness in 2026. Original Medicare covers none of that.
A good fit if you have Medicaid too. Humana runs 147 dual-eligible special needs plan segments in 2026. See dual-eligible special needs plans before enrolling in a standard plan you may not need.
Think twice if you travel or split the year between states. Service areas are county-based, and an HMO outside its network pays nothing except in emergencies.
Think twice if you have a specialist you refuse to give up. Humana’s network can change mid-year, and a Gold Plus HMO gives you no out-of-network fallback.
Think twice if you want to switch to Medigap later. That is the trap nobody warns about, and it deserves its own section.
Humana Medicare Advantage vs Original Medicare Plus Medigap
| Humana Medicare Advantage | Original Medicare plus Medigap | |
|---|---|---|
| Monthly cost | $0 to $189 plan premium plus $202.90 Part B | $202.90 Part B plus a Medigap premium set by the insurer |
| Yearly out-of-pocket limit | Yes, $375 to $9,250 in network | No federal limit, but Medigap absorbs most cost sharing |
| Provider choice | Plan network, county service area | Any provider that accepts Medicare, nationwide |
| Referral to a specialist | Required on Gold Plus HMO plans | Not required in most cases |
| Prior authorization | Required for certain services on every Humana plan | Not required in most cases |
| Drug coverage | Built in on 798 of 887 Humana plans | Separate Part D plan required |
| Dental, vision, hearing | Included on almost all plans | Not covered |
| Can you buy Medigap? | No. Medicare.gov states you cannot buy Medigap to cover Medicare Advantage out-of-pocket costs | Yes |
The asymmetry is the whole decision. You can move into Medicare Advantage during any Medicare open enrollment period. Moving back out to Original Medicare and buying a Medigap policy is harder, because your guaranteed right to buy Medigap without medical underwriting is a 6-month window that starts the first month you are 65 and enrolled in Part B. Medicare.gov’s own language after that window: “there’s no federal guarantee that an insurance company will sell you a Medigap policy,” and if one does, “it may cost more due to past or present health problems.”
So the honest framing is that a $0 Humana premium today can cost you the option of a Medigap policy at 72. Our Medicare Advantage versus Medigap comparison walks the trade in detail, Medicare Advantage versus Original Medicare covers the coverage side, and Medigap cost shows what the alternative premium actually looks like.
The Bottom Line
Humana publishes more than most carriers. Every plan has a public Summary of Benefits PDF with exact copays, out-of-pocket maximums, and drug deductibles, and CMS publishes the premium for every plan in every county. What Humana does not do is put a price on any consumer page, which makes the ZIP code lookup unavoidable.
Do three things before you enroll for 2026. Pull the Summary of Benefits for the exact plan number, not the brand name, because Gold Plus alone spans 178 different plans. Check the drug deductible, since most Humana plans charge the full $615. And confirm your doctors are in network for that specific plan, not just “Humana.”
One timing note. Everything on this page is 2026 plan year data. CMS said in its July 28, 2026 Part D bid announcement that it would release the 2027 Medicare Advantage and Part D landscape in mid to late September 2026, and the 2027 annual enrollment period runs October 15 to December 7, 2026. Prices, copays, and out-of-pocket caps will change. Compare against Aetna, Anthem, Kaiser Permanente, Cigna, Wellcare, and Devoted Health in your county, and if money is tight, check whether you qualify for Medicare Savings Programs or Extra Help first, because those cut the Part B premium you are paying no matter which plan you pick.