Is Humana in trouble financially?
Asked by: Alexa Powlowski | Last update: May 5, 2025Score: 4.9/5 (13 votes)
Why is Humana struggling?
The main contributor to Humana's ratings decline involves its largest Medicare Advantage contract, which covers 2.8 million of its members. That plan slipped from 4.5 stars to 3.5 going into 2025. CVS Health similarly had its biggest Medicare Advantage contract downgraded two years ago.
What states is Humana pulling out of?
Similarly, because of CVS Health Aetna's moves, Humana now feels secure with losing 5% of its Medicare Advantage plan enrollees after it exits unprofitable markets, primarily in the Southeastern states of Florida, North Carolina, Georgia, Texas, and Illinois.
How is Humana doing financially?
Overall, Humana posted revenue of $29.4 billion in the quarter, up more than 11% year over year. Still, the insurer's net income of $480 million is almost half of Humana's $832 million profit at the same time last year.
Is Humana insurance in financial trouble?
Analysts expect Humana's earnings to drop 38% in 2024, to $16.18 per share from $26.09 in 2023, according to FactSet. Analysts had been anticipating a recovery in 2026, with earnings climbing back to $25.77 per share.
Humana Benefits Card/ Expires12/31. Part2
What is going on with Humana insurance?
Humana has announced that it will be exiting the Employer Group Commercial Medical Products business, which includes all fully insured, self-funded and Federal Employee Health Benefit medical plans, as well as associated wellness and rewards programs. No other Humana health plan offerings are materially affected.
What went wrong at Humana?
Humana's stock dived when it announced a sharp decline in memberships for the top-rated Medicare Advantage (MA) plan. There are serious concerns among investors that the company may not be as attractive an income investment play as it used to be. Humana earns revenue through healthcare services and health insurance.
What is the future of Humana in 2024?
But UnitedHealth leaders also have stressed that the rising costs wouldn't affect their expectations for 2024. Humana Inc. said Thursday that it expects adjusted earnings of about $16 per share for the new year. Analysts had been projecting per-share earns of $29.14, according to the data firm FactSet.
Where does Humana rank in HealthCare?
U.S. News ranked Humana No. 1 nationally for its 2024 Medicare Advantage plan offerings in the following categories: 2024 Best Overall Medicare Advantage Plan Company. 2024 Best Company for Member Experience.
What is the two midnight rule for Humana?
What is the two-midnight rule? The two-midnight rule, enacted in 2013, states that traditional Medicare must pay for an inpatient stay if admitting clinicians anticipate patients will remain in the hospital for at least “two midnights.” Beginning this year, Medicare Advantage insurers must also follow the rule.
What is the downside of Humana?
High cost limits: Humana's average maximum out-of-pocket limit on plans is the highest of the major providers.
How much does Humana cost per month for seniors?
Premiums for Humana's plans start at $0 per month in addition to your Medicare Part B premium. In 2024, the standard part B premium amount is $174.70, but this number can go all the way up to $594 per month for high-earning seniors3.
Why are hospitals not taking Humana Medicare Advantage?
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.
Why did Humana lose star ratings?
More than one dozen of Humana's plans received lower stars because of the higher cut points, the payer said. Humana also accused the CMS of not giving the insurer a chance to verify regulators' calculations, in a break with historical norms.
Who is the largest Medicare Advantage provider?
- UnitedHealthcare is the largest provider of Medicare Advantage plans. ...
- Aetna is a CVS Health company and is the fourth-largest provider of Medicare Advantage plans.
Why is Humana down so much?
Shares of Humana have sunk since the CMS rating came out last week, adding to a slump that began in January when the company first warned that higher medical costs and government regulations would hurt profits. Investopedia requires writers to use primary sources to support their work.
Who is Humana's biggest competitor?
The main competitors of Humana include Elevance Health (ELV), The Cigna Group (CI), Centene (CNC), Molina Healthcare (MOH), UnitedHealth Group (UNH), Oscar Health (OSCR), Alignment Healthcare (ALHC), Clover Health Investments (CLOV), Trupanion (TRUP), and NeueHealth (NEUE).
Which health insurance denies the most claims?
According to the analysis, AvMed and UnitedHealthcare tied for the highest denial rate, with both companies denying about a third of in-network claims for plans sold on the Marketplace in 2023, respectively.
Who is the number 1 healthcare company in USA?
1. UnitedHealth Group (UNH) UnitedHealth Group holds its position at the forefront of the healthcare sector, pushing the boundaries of digital and personalized care.
What went wrong with Humana?
Humana slashed its guidance after the first quarter following the Centers for Medicare & Medicaid Services' decision to cut the MA benchmark rate by 0.16%. Large payers have since blamed the cuts on reduced benefits and the rollback of coverage areas for next year.
Why is Humana dropping Medicare?
Rising medical costs and lower reimbursements from CMS led Humana and other insurers to plan market exits in 2025.
Did UnitedHealthcare buy out Humana?
United HealthCare Corp.'s acquisition of Humana Inc., once valued at $5.5 billion, has been derailed by a plunge in United's stock price. The companies said today that they mutually agreed to scrap the deal, which would have created one of the nation's largest managed-care companies.
Is Humana reputable?
Humana, Inc. is BBB Accredited.
This business has committed to upholding the BBB Standards for Trust.
Why do people say not to get a Medicare Advantage plan?
Disadvantages of Medicare Advantage plans can include difficulty switching out of the plans later, restrictions on care access, limited provider networks, and limitations on extra benefits.
Is Humana deducted from Social Security?
For most people, paying the premium is simple. Your Part B premium will be automatically deducted from your benefit payment if you get benefits from 1 of these: Social Security.