Why is Humana falling?
Asked by: Korbin Lind PhD | Last update: June 23, 2025Score: 4.7/5 (4 votes)
Is Humana in financial trouble?
Like other health insurers, Humana has been battling with elevated costs due to higher demand for medical care, and lower-than-expected payments from the government for managing healthcare for these members.
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.
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.
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.
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What is going on with Humana?
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 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.
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.
Who is the competitor of Humana?
Humana's competitors and similar companies include CVS Health, Aetna, Molina Healthcare, Cigna, Elevance Health and UnitedHealth Group. Humana (formerly known as Heritage House of America) is a company that provides health insurance services. CVS Health is a provider of pharmacy healthcare solutions.
Is Walmart in network with Humana?
With your Humana Select Rx Network, your in-network retail pharmacies are Walmart, CVS (including Target locations), HEB and Publix. The Walmart network of stores includes Walmart, Sam's Club, Neighborhood Market and Walmart Express. Many CVS locations are open 24 hours a day, seven days a week.
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 are people dropping 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 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 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 Humana changing their name to?
Effective June 11, 2022, Humana Pharmacy® becomes CenterWell Pharmacy™. This name change reflects the pharmacy's commitment to put your patients at the center of all it does. This brand change also applies to Humana Specialty Pharmacy®, which becomes CenterWell Specialty Pharmacy™.
Did UnitedHealthcare buy 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 is Humana now called?
The CenterWell strategy
Humana restructured into two businesses in 2022: its insurance benefits segment and health services arm CenterWell. Along with offering specialty and retail pharmacy, CenterWell says it is the largest provider of senior-focused primary care and home healthcare in the U.S.
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.
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 stock down so much?
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 do doctors not like Medicare Advantage plans?
Across the country, provider grumbling about claim denials and onerous preapproval requirements by Advantage plans is crescendoing. Some hospitals and physician practices are so fed up they're refusing to accept the plans — even big ones like those offered by UnitedHealthcare and Humana.
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 is going on with Humana Medicare?
Humana is committed to providing our Medicare Advantage members with access to high-quality, effective and affordable care. Humana Medicare Advantage members are being notified that our contract with Trinity Health will end if a new agreement is not reached before it expires effective Jan. 1, 2025.