Health Insurance Reviews




Humana One Review from Wisconsin

I have a Wisconsin individual PPO family health plan through Humana One. It's called the Portrait Share 80 and the family deductible is $5,000. With me on this plan are my two children ages 5 and 8 and our monthly premium is about $363. For a single mom this is a bit much for me on premium, but I am very happy with the coverage so I keep paying my premium. This plan is much like group insurance as in Humana covers us at 80% and we are responsible for the remaining 20% once our deductible has been met. We have unlimited doctor office visits co-pays for $35, and unlimited specialist visits for $50. This does not include services rendered during the visit. Which means any diagnosis or treatment we receive during that visit we have to pay for, out-of-pocket, at Humana's negotiated rate (if I go to a doctor in-network) until my deductible is met. The negotiated rate is good as things like x-rays for the kids and some random tests we had to do had a well adjusted rate.

Our family's Humana One deductible will not be met until two people from our family meet their individual deductible. The individual deductible is $2,500 which is why only two people have to meet that deductible to satisfy the family's $5,000 deductible. This also means that one person will not be able to satisfy the family's deductible alone. So if I end up with a hospital bill for $10,000, our family deductible is not met, although I have satisfied my individual deductible. When I hit the $2500 deductible I am also eligible for the 80% coverage. I think this is standard with most insurance. We have out-of-network coverage that will cover us at a 60% after we reach our deductible. Any money paid for out-of-network services still goes towards our plans deductible, however, our plans deductible doubles if we go out-of-network. But, if we are in a situation where we have no choice but to use an out-of-network doctor, such as a medical emergency in which we cannot be transported to an in-network provider, we will be billed as in-network. I did have to use my plan when I was in Chicago, and I was still in Humana's network. It was great because they transferred the medical records over to St. Mary's in Green Bay.

We do have dental on this plan, but not vision as it was not offered as an addition to our plan. Dental covers our preventatives at 100%. We each get two free cleanings a year and major services are covered. I have only used the dental for getting my kids teeth cleaned, however, I do see that I have thumb sucking coverage available with dental. This will be something I will now use for my 5 year-old and this will be covered at 50%. There is a 6 month waiting period which we have already satisfied. All-in-all Humana One is great coverage for people in Wisconsin who have to purchase their own health insurance.

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