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Humana Monogram Plan


(Click here to view all Humana Plans available in Colorado)

Humana Monogram Plan
Humana HSA
Instant Quotes How to Apply
Coverage Synopsis Optional Benefits Rate Information PPO Networks Underwriting Effective Dates About Humana

 

The HumanaOne Monogram health plan is a low cost health plan that covers major incidents providing a safety net of coverage if you ever need it. It also includes a benefit for annual visits. This plan is good if your employers doesn't offer a group plan, if you are a young adults whose parents health insurance no longer covers you, or if you work part time and don't qualify for your employer's group plan. With this plan you can choose the coverage you want without spending unnecessarily on benefits you'll never use.

Please view the Monogram Plan Brochure to see detailed information including Plan Provisions, Limits & Exclusions, and State Variations:

Total Plus Rx Humana Monogram Adobe help

 

 

Plans at a Glance:

The Monogram Total Plus Rx offers two deductibles of $7,500 or $15,000.  After you meet this deductible the plan pays 100% of your medical expenses up to your lifetime maximum. However, it covers 100% of your preventive care before your deductible with participating providers. It also covers 100% of your prescription drugs after a $1,000 deductible and copay.

Total Plus Rx
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)
Please run an Instant Quote to find deductibles in your area Please run an Instant Quote to find deductibles in your area
Maximum Out-of-Pocket Expense
(after deductible
  • Individual (must be satisfied by each covered person)
Individual
$0
Family
 $0
Individual
$5,000
Family
$10,000
Preventive Care
  • Well-child care (including immunizations) (birth to age 13)
  • Routine annual PSA and digital rectal exam
  • Routine annual Mammograms
100% covered You pay 25% coinsurance
  • Routine Annual physical exam (age 13 and older)
  • Routine immunizations
    (age 13 to 18)
  • Routine pap smear
100% covered Not Covered
  • Routine lab, pathology and X-ray
100% covered after deductible Not Covered
Physician Services
  • Office visits: 
    (includes diagnostic lab and X-ray)
  • Allergy testing, injections, and serum
  • Inpatient services
  • Outpatient services (includes surgery)
100% covered after deductible You pay 25% coinsurance
Hospital
Services
  • Inpatient care
  • Outpatient surgery - facility
  • Outpatient nonsurgical
  • Newborn hospital stay
100% covered after deductible You pay 40% coinsurance after deductible
  • Emergency room (includes physician visits)
100% covered after $125 copayment per visit and deductible (copayment waived if admitted) You pay 25% 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.)
$1,000 prescription drug deductible per individual $1,000 prescription drug deductible per individual
  • Benefit for each prescription or refill (up to 30-day supply)
100% after: 70% after:
  • Level One - lowest copayment for lowest cost generic and brand-name drugs
$15 co-pay, not subject to prescription deductible $15 co-pay, not subject to prescription deductible
  • Level Two - higher copayment for higher cost generic and brand-name drugs
$35 co-pay after prescription drug deductible $35 co-pay after prescription drug deductible
  • 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
$55 co-pay after prescription drug deductible $55 co-pay after prescription drug deductible
  • Level Four - highest copayment for high-technology drugs (certain brand-name drugs, biotechnology drugs and self-administered injectable medications
25% co-pay up to $2,500 out of pocket maximum per year 25% co-pay up to $2,500 out of pocket maximum per year
  • Mail Order (90 day supply)
100% covered after three times the retail copayment 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
  • Hospice
  • Complications of pregnancy and sick baby services
  • Transplant services (organ) **
100% covered after deductible

 

 

** when services are performed at a National Transplant Network provide
You pay 25% coinsurance after deductible

 

 

** when services are performed at a National Transplant Network provide
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
$5 million per covered person $5 million per covered person
  • $500 Supplemental Accident Benefit
First $500 per accident covered at 100%, then base plan benefits apply First $500 per accident covered at 100%, then base plan benefits apply
  • $1000 Supplemental Accident Benefit
First $1000 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:  This chart contain a general summary of benefits, exclusions, and limitations.  Please refer to the Monogram HSA Plan brochure for the actual terms and conditions that apply:

Total Plus Rx Humana Monogram Adobe help

Humana Monogram Plan

Coverage Synopsis:

Share 80 Plus Rx and unlimited Copay

The Monogram Total Plus Rx pays 100% of your medical costs after your deductible is met. For non-participating providers, the plan pays 75% of the costs after your non-participating provider deductible is met.  The plan also pays 100% of preventive services 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). The plan also pays for 100% of your prescription drugs after your $1,000 prescription drug deductible and corresponding co-pay are met. 

Lifetime maximum is $2 million, and can be increased to $5 million with the optional lifetime maximum benefit.

With the Monogram Plan you can enjoy these extra benefits:

  1. 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
  2. Access to MyHumana for helpful health plan information, medical information, cost savings tips, and tools
  3. The convenience of a one-stop destination for life, dental, and individual health insurance

Humana Monogram Plan

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.

Humana Monogram Plan

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.

Humana Monogram Plan

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.

Humana Monogram Plan

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.

Humana Monogram Plan

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 800-913-6381 and see if Carol can put you through to one of our Personal Benefits Consultants. For more information on how to choose a plan and apply for coverage, see our Consumer's Guide page.

Humana Monogram Plan

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.

 

"I couldn’t feel more comfortable with my decision."

"My name is Keith Guastella and I am a new client of agent/broker Chelsea Miller.  I wanted to take this moment to express my sincere compliments regarding the service I recently received.  Chelsea has been the utmost professional from first contact.  Prior to meeting Chelsea, I shopped for close to a month for insurance and felt confused and uneasy about the products and process.  Chelsea provided me sound guidance, follow-up, patience, and expertise.  She made recommendations, called to make sure my current Doctor was in network, routed me to online resources, and assisted real-time as I completed the application process. In the end, I couldn’t feel more comfortable with my decision..

Many thanks to her.....and your company!

Keith Guastella
Longmont, CO
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