Humana
Coverage of Humana in the Nexus archive.
- 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.