What is going on with Humana?
Asked by: Mr. Ezequiel Rempel IV | Last update: July 13, 2025Score: 4.6/5 (73 votes)
Is Humana in trouble financially?
Humana shares, among the sector's most hard hit, have fallen nearly 44% so far this year, after the company withdrew its 2025 forecast previously, citing disappointing government Medicare reimbursement rates.
Is Humana Insurance having problems?
Humana's plummeting stars continue a run of misfortune for the Kentucky-based payer. More so than most of its peers, Humana — the second-largest MA provider in the U.S. — has struggled to contain rising costs in MA and been forced to roll back its plan offerings in a bid to preserve profits.
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.
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.
Top Humana Medicare Advantage Plans for 2024 Explained | Humana Medicare
Is Humana insurance closing down?
Humana will move out of commercial plans over the next 18 to 24 months and focus more on government-funded programs and specialty businesses. Included in the business Humana is leaving are all fully insured, self-funded, and Federal Employees Health Benefits medical plans.
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.
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.
What is the new name for Humana?
During 2022, the Home Health division of Humana-owned Kindred at Home is transitioning to the CenterWell brand – becoming CenterWell Home Health. Also in 2022, Humana's pharmacy business has adopted the CenterWell name, becoming CenterWell Pharmacy and CenterWell Specialty Pharmacy.
What is going on with Humana insurance for seniors?
Humana, the country's second largest Medicare Advantage insurer, is aggressively culling its plan offerings after several quarters of spending more than expected on its members' medical care, and getting hammered on Wall Street for it.
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.
Why is Humana falling?
And yet HUM share price is down 33% year-to-date. Why is Humana stock dropping? Humana stock has been dropping this year due to higher Medicare Advantage costs that have hurt medical loss ratios as service usage rose.
Why are hospitals refusing Medicare Advantage plans?
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.
What are the Humana allegations?
Whistleblower Steven Scott filed the lawsuit in 2016 alleging that Humana was inflating its costs in order to get a higher paying contract from the government, though the insurer was providing below the required level of coverage.
Is Humana getting out of 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 rank is Humana?
Humana Inc. is an American for-profit health insurance company based in Louisville, Kentucky. In 2023, the company ranked 42 on the Fortune 500 list, which made it the highest ranked (by revenues) company based in Kentucky. It is the fourth largest health insurance provider in the U.S.
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.
What went wrong with Humana?
Investors are fleeing Humana after the Centers for Medicare and Medicaid Services cut the quality rating of the company's largest Medicare Advantage plan.
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.
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.
Is Humana good or bad?
About Humana
Humana has an average rating of 1.9 from 50 reviews. The rating indicates that most customers are generally dissatisfied. The official website is humana.com. Humana is popular for Insurance, Financial Services.
Why is Humana dropping Medicare?
Rising medical costs and lower reimbursements from CMS led Humana and other insurers to plan market exits in 2025.
Is Humana suing the government?
Humana “moved the goalposts and now accuse Defendants of missing a field goal. Their motion should be denied,” the DOJ filing said. Humana sued the CMS to contest its 2025 “star ratings,” which determine how much it will receive in 2026 from the Medicare Advantage Quality Bonus Payment program.