UnitedHealthcare vs. Humana Insurance

We have found that UnitedHealthcare is the better insurance company overall in terms of size and the variety of insurance plans it offers. Humana does have better ratings from customers and companies, but the types of plans are limited when compared to UnitedHealthcare. Humana, however, is cheaper than UnitedHealthcare, which may be what’s most important to you. Humana offers dental and vision coverage as does UnitedHealthcare. If you need individual or family medical and hospital coverage then you’ll need to go with UnitedHealthcare as Humana no longer offer these types of plans, only through employers. Such coverage can only be purchased through an employer who offers health insurance through Humana. Below is an in-depth look at both companies so you can make the best decision for your healthcare needs.

UnitedHealthcare Vs Humana: A Quick Glance

We've made it easy to compare companies side by side. See how UnitedHealthcare and Humana ranked among industry ratings, plan types, availability, and more.

Comparison	UnitedHealthcare	Humana
Year Founded	1977	1961
Medicare Star Rating	4.5 stars (out of 5)	3 stars (out of 5)
NAIC Complaint Index	None	1.04% for individual health insurance
Availability	50 states (insurance types vary by location)	50 states (insurance types vary by location)
Coverage Limit	Varies	Varies
Deductible	Varies	Varies
Maximum Annual Benefit	Varies	Varies
Waiting Period	Varies	Varies
Providers In-Network	1.3 million physicians and care professionals and 6500 hospitals and care facilities	More than 22,000 physicians and clinicians
Covers Telehealth	Yes (depending on need, your plan, and location)	Yes (depending on plan)
Policy Management	Mobile app, online account, phone	Mobile app, online account, phone

UnitedHealthcare Pros and Cons

Pros	Cons
Robust health plans and benefits for Medicare and Medicaid recipients	Plans are generally more expensive than those of other health insurance providers.
Marketplace plans for individuals and families that do not qualify for Medicaid or Medicare
Offers telehealth for customers

Humana Pros and Cons

Pros	Cons
Trusted and reliable source for Medicare Supplements and Medicare Advantage	No longer offers individual and family healthcare plans for hospital and medical coverage
Offers commercial health insurance options
Offers telehealth for customers

UnitedHealthcare Vs Humana: Plan Structures

UnitedHealthcare and Humana offer dental, employer-based insurance, Medicaid, Medicare, and vision coverage. UnitedHealthcare offers far more coverage than Humana, however, adding family, individual, self-employed, short-term, student, and supplemental insurance.

Plan	UnitedHealthcare	Humana
Dental	✓	✓
Employer-based coverage	✓	✓
Family	✓	X
Individual	✓	X
Medicaid	✓	✓
Medicare	✓	✓
Self-employed	✓	X
Short-term	✓	X
Student	✓	X
Supplemental (accidental, critical illness, hospitalization, indemnity, and international travel)	✓	X
Vision	✓	✓

UnitedHealthcare Vs Humana: Plan Availability

Both UnitedHealthcare and Humana are offered nationwide. However, plans offered by both companies will differ depending on your location.

UnitedHealthcare Vs Humana: In-Network Providers

UnitedHealthcare boasts an impressive 1.3 million physicians and care professionals and 6500 hospitals and care facilities that are in-network. Humana offers over 22,000 physicians and clinicians.

UnitedHealthcare Vs Humana: Cost

Healthcare costs vary due to several factors. They include:

• Age
• Deductible
• Health history
• Health plan
• Insurance company
• State

UnitedHealthcare and Humana offer Medicare coverage, which includes Medicare Advantage (Part C), Medicare Supplement (Medigap), and Medicare Part D (prescription drug coverage). Part C is a comprehensive health insurance package that combines Part A (hospital insurance), Part B (medical insurance), and usually Part D of Medicare. The monthly premium for Medicare Advantage will need to be paid along with the premiums for Parts A and B. The 2022 average is $19 per month.

Medigap helps cover holes in your Part A and Part B plans but will not cover prescription drugs. Like Medicare Advantage, you will need to pay the Medigap monthly premium along with the monthly premiums for Parts A and B. Part D offers prescription drug coverage. The average 2022 premium for Part D is $33 per month which must be paid in addition to the Part A premium and Part B premium. Part D deductibles vary by plan.

UnitedHealthcare Vs Humana: Policy Management

UnitedHealthcare and Humana members can access their health insurance plans through a mobile app, online portal, or by speaking with a representative. Humana’s online portal is through a third-party company called Availity. Both the online portal and mobile app for UnitedHealthcare and Humana give customers the ability to:

• Compare costs
• Find healthcare providers
• Pay bills
• Track spending
• View claim status

UnitedHealthcare Vs Humana: Coverage Limits

Health insurance companies aren’t allowed to set a dollar limit on services that are considered essential health benefits while enrolled in a health insurance plan. Essential health benefits include:

• Ambulatory patient services
• Emergency services
• Hospitalization (surgery and overnight stays)
• Laboratory services
• Mental health and substance use disorder services
• Pediatric services
• Pregnancy, maternity, and newborn care
• Prescription drugs
• Preventive and wellness services/chronic disease management
• Rehabilitative and habilitative services and devices

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UnitedHealthcare Vs Humana: Medical Loss Ratio

Medical loss ratio (MLR) is the amount of revenue brought in by premiums from an insurance company that is used for clinical services and quality improvement. Insurance companies are required to spend at least 80% for individuals or 85% for groups of premium dollars on medical care improvements. If the MLR doesn’t hit 80% or 85%, the difference is refunded in the form of a rebate for policyholders. Humana’s medical loss ratio in 2020 was 85.8%. UnitedHealthcare issued individual rebates in 2020 in Florida as well as group rebates in 30 states, which include:

• Arizona
• Arkansas
• Colorado
• Delaware
• Florida
• Georgia
• Hawaii
• Illinois
• Iowa
• Kentucky
• Louisiana
• Maryland
• Massachusetts
• Michigan
• Minnesota
• Missouri
• Nebraska
• Nevada
• New Jersey
• New Mexico
• New York
• Ohio
• Oklahoma
• Oregon
• South Carolina
• Tennessee
• Texas
• Virginia
• Washington
• Wisconsin

UnitedHealthcare Vs Humana: Enrollment Process

Open enrollment for health insurance for 2023 begins November 1st of this year. Coverage through UnitedHealthcare can be purchased at this time through the health insurance marketplace. Each state has its own marketplace. Coverage can be purchased outside of the enrollment period if there has been a qualifying event, such as:

• Becoming a U.S. citizen
• Changing jobs
• Getting married or divorced
• Giving birth to a child or adopting a child
• Household income falling below the federal poverty level
• Losing health coverage (spouse or domestic partner loses their job or dies)
• Moving homes

Humana does not fall under the normal enrollment rules as it does not offer individual or family plans. Instead, you will fill out an online form. You will begin by giving:

• the state you live in

and

• your age

You will then be given a list of potential options for vision coverage, dental coverage, or both. Once you’ve chosen the plan you want, you will be prompted to checkout and pay for your plan. During this process you will be asked your: 

• Name
• Date of birth
• Gender

and

• Any additional people you want covered on your policy

Next, you’ll be prompted to give your mailing address, email, and phone number. You can pay using Mastercard, Visa, or by automatic check draft. You can also dictate whether you will pay monthly or annually as well as set the recurring payment date. The recurring payment date can be the 5th, 15th, or 25th of the month.

Medicare Advantage is offered through UnitedHealthcare and Humana, which has its own open enrollment from January 1st to March 31st each year. Medicare supplement (Medigap) and prescription drug coverage (Part D) are also offered. In order to get them, you will need Original Medicare (Part A and B). Open enrollment for Original Medicare is from October 15 to December 7 of each year. You can enroll in Medicare outside of this period if you are getting Original Medicare for the first time.

UnitedHealthcare Vs Humana: Policyholder Experience

Below is a table showing ratings based on customer reviews and company reviews from several online sources for both UnitedHealthcare and Humana.

Company	UnitedHealthcare	Humana
Consumer Affairs	1.5/5 stars	2.5/5 stars
Insure	2.7/5 stars	4.16/5 stars
BestCompany	3.2/5 stars	3/5 stars
Affordable Health Insurance	4.7/5 stars	4.6/5 stars
BBB	1.08/5 stars	1.38/5 stars

How To File Claims With UnitedHealthcare and Humana

In-network care does not require a claim to be filed by the insured. Instead, doctors and medical facilities file claims with the insurance company. However, medical services acquired from out-of-network will require you to file a claim yourself. UnitedHealthcare and Humana allow users to file claims using an online portal. UnitedHealthcare uses an in-house portal for customers while Humana directs claims to a third-party called Availity. Both companies also have printable claim forms that can be filled out and submitted to the appropriate address.

History of UnitedHealthcare

UnitedHealth Group was founded in 1977 by Richard Burke and went public in 1984. It was Dr. Paul Ellwood, who coined the term “health maintenance organization,” and who helped Burke start up UnitedHealth. In 1979, the company created the first network senior health plan.

History of Humana

Humana was founded by David A. Jones Sr in 1961 as a nursing home company called Extendicare. In 1972 Extendicare divested the nursing home business and moved into the hospital business. They changed the name to Humana in 1974.

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Choose the Company That's Right for You

UnitedHealthcare is a larger insurance company and offers more plans for its customers. Humana has fewer plans, but their ratings are better than UnitedHealthcare’s almost across the board. While Humana may not offer individual or family health insurance, it does offer Medicare plans, dental, and vision plans at a lower cost than UnitedHealthcare. To help find the best health insurance plan, use SmartFinancial to make sure you’re getting the plan you want for the price you want. Enter your zip code below or call 855.214.2291 to receive your free health insurance quotes.