Humana
Coverage of Humana in the Nexus archive.
- Medicare to end prescription subsidy program
Medicare will end a subsidy program that reduced prescription drug plan premiums, as insurers can now price plans accurately without it. The Centers for Medicare & Medicaid Services (CMS) claims premiums will rise by less than $10 for most recipients, with some seeing lower costs. The subsidy, which averaged a $16 reduction, supported Medicare Part D plans offered through private insurers like UnitedHealth Group, Humana, and Aetna.
- Humana slashed its annual profit forecast as lower Medicare ratings squeezed bonuses
Humana, a health insurer, reduced its annual profit forecast to at least $6.52 per share from $8.36 due to lower Medicare ratings affecting bonuses.
- Readers Share Personal Insights on Deadly Denials and Pregnancy Centers
Two letters discuss healthcare challenges: one describes a man's suicide linked to delayed COPD medication approval, and another addresses insurance barriers for weight loss drugs. A third letter mentions pregnancy centers, though details are incomplete.
- STAT+: Medicare Advantage insurers face new bipartisan scrutiny over AI and care denials
Sens. Richard Blumenthal (D-Conn.) and Josh Hawley (R-Mo.) are demanding Medicare Advantage insurers provide records and details about their use of AI to deny care. The bipartisan effort follows a government investigation revealing ongoing denials in the program, with lawmakers challenging insurers' claims of reducing barriers to medical services.
- She Struggled To Get a Lifesaving Drug Even After Insurers Vowed To Help
Margaret Hvatum, a 70-year-old with primary immunodeficiency, faced insurance denials for her lifesaving drug Hizentra after switching Medicare Advantage plans, leading to health complications and denied hospital charges. The denial stemmed from prior authorization issues, a process that contributed to her hospitalization and financial burden.
- STAT+: Private Medicare plans erect barriers to rehab care in pursuit of profit, federal investigators find
Federal investigators found that dominant Medicare Advantage insurers, including UnitedHealth Group and Humana, denied rehabilitative care for older and disabled Americans at higher rates than peers, with 97% of denials overturned upon patient appeal. These insurers used a UnitedHealth subsidiary, NaviHealth, which employs AI to assess care needs, but frequently reversed its denials after scrutiny during appeals.
- A New Medicare Option for Weight Loss Drugs: What Older Americans Should Know
Medicare beneficiaries may be able to get a GLP-1 prescription for weight loss for $50 a month starting in July, a notable shift for Medicare which has long been barred from covering weight loss treatments. The drugs, such as Wegovy and Zepbound, are effective but can be expensive without insurance coverage. This new benefit is part of the Medicare GLP-1 Bridge program, a short-term pilot program.