Why did Humana fall?
Asked by: Neal Weimann | Last update: December 3, 2025Score: 4.9/5 (46 votes)
What went wrong with 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.
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.
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.
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.
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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.
Is Humana good or bad?
Humana Medicare Advantage plans are rated below the industry average, receiving an average rating of 3.63 stars out of 5 from the Centers for Medicare & Medicaid Services (CMS) for 2025, weighted by enrollment. For comparison, the average weighted star rating for plans from all providers is 3.95.
Why is Humana crashing?
The company said the main reason for that drop is that the 2025 rating for its H5216 plan, which contains about 45% of Humana's MA membership, fell to 3.5 stars from 4.5 stars in 2024. The H5216 plan also includes more than 90% of its employer group waiver plan membership.
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.
Will Humana be available in 2025?
Because of the popularity of the plans, Humana is expanding access with availability in 20 states in 2025.
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.
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.
Why was Humana downgraded?
The ratings downgrade Humana Health of Puerto Rico Group and outlook revision to negative reflect its weakening risk-adjusted capitalization measures, driven by significant operating losses since 2023.
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 changing its name?
Why is Humana Pharmacy changing its name? The new CenterWell name reflects the combination of patient centricity, wellness and care that is fully centered on the patient.
What is the Humana controversy?
Humana Agreed to Pay $1.8 Million for Allegedly Violating the Civil Monetary Penalties Law by Submitting Prescription Drug Event Claims that Improperly Claimed Sales Tax. Humana Inc. (Humana), Kentucky, agreed to pay $1,814,000 for allegedly violating the Civil Monetary Penalties Law.
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.
Who is the parent company of Humana?
In July 2015, Aetna announced that it would acquire Humana for $37 billion in cash and stock (approximately $230 a share at that time).
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.
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.
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.
Is Humana insurance having problems?
The insurer posted $1.4 billion in net income in the first half of this year, down more than a third from the same period in 2023. To protect profits, Humana and its peers in MA slashed their plans for 2025, cutting benefits and exiting underperforming markets.
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.
What changes are coming to Humana in 2025?
In 2025, the Part D “donut hole” will close
In 2025, the Part D “donut hole,” or coverage gap, will close. Once you reach your Part D deductible, you'll pay no more than 25% of the cost for Part D drugs covered by your plan until you reach the new maximum out-of-pocket drug cost of $2,000.