A Humana Special Needs Plan (SNP) is a type of Medicare Advantage planA type of Medicare health plan offered by a private company that contracts with Medicare to provide ... built for one of three specific groups: people who have both MedicareA federal health insurance program for people who are 65 or older, certain younger people with disab... and MedicaidA state and federal program that provides health coverage to eligible low-income adults, children, p..., people with a qualifying chronic condition like diabetesA chronic condition that affects the way the body processes blood sugar (glucose), requiring ongoing... or heart failure, or people who need long-term careA range of services and supports to meet health or personal care needs over an extended period of ti... in a nursing facility. Every Humana SNP bundle includes Original Medicare (Parts A and B), prescription drug coverage (Part D), and a dedicated care coordinatorA professional who organizes and manages a patient's care plan, coordinating between different healt... in one plan.
As the second-largest Medicare Advantage carrier in the country, Humana had about 7.1 million Medicare Advantage members as of March 31, 2026, after strong 2026 enrollment growth. The company also expanded its SNP footprint into new states for 2026 while reducing its overall Medicare Advantage county footprint in some markets.
This guide explains which Humana SNP fits which situation, what each one costs in 2026, and how to enroll. If you're new to Medicare Advantage as a category, our Medicare Advantage Enrollment Guide for Seniors covers the basics first.
A Humana Special Needs Plan is a Medicare Advantage Part C plan that limits enrollment to seniors and disabled adults who meet specific criteria around income, health, or care setting. Every SNP rolls hospital coverage, medical coverage, and prescription drug coverage into a single plan and assigns each member a care coordinator who follows up on appointments, medication adherence, and care gaps.
Congress created SNPs through the Medicare Modernization Act of 2003 and made them permanent under the Bipartisan Budget Act of 2018. Today, every SNP, including Humana's, has to follow a Model of Care approved by the National Committee for Quality AssuranceA way of preventing mistakes and defects in manufactured products and avoiding problems when deliver..., or NCQA. That framework is what separates SNPs from regular Medicare Advantage plans: the plan is required to identify each member's specific needs, coordinate services across providers, and document outcomes in a way standard plans never have to.
According to Humana's own member education page, every Humana SNP includes Part D prescription drug coverage, and most also add routine dental, vision, and hearing care that Original Medicare doesn't cover. SNPs have grown faster than general Medicare Advantage plans in recent years, and Humana is one of the carriers leaning into that growth in 2026.
Humana offers all three SNP categories that the Centers for Medicare & Medicaid Services (CMS) recognizes. Each one targets a different population, and the eligibility criteria are not interchangeable. You qualify based on which box you fit, not on which extra benefits look most attractive.
A Humana D-SNP is for people who qualify for both Medicare and Medicaid. This group is often called "dual eligible." Most members are 65 or older with low income, but some are younger adults with disabilities who became Medicare-eligible early.
D-SNPs coordinate the two programs into one card, one provider network, and one customer service line. Many Humana D-SNPs include a Healthy Options Allowance, a prepaid card that pays for eligible over-the-counter products, groceries, utility bills, or rent, depending on the plan and the member's qualifying conditions. Most D-SNP members pay $0 in plan premiums because Medicaid picks up the cost-sharing.
A Humana C-SNP is for people with a serious or disabling chronic condition that CMS has officially recognized as a qualifying diagnosis. Qualifying conditions include diabetes mellitus, cardiovascular disorders, chronic heart failure, chronic lung disorders, and chronic and disabling mental health conditions, among others. A doctor has to verify the diagnosis in writing within 60 days of enrollment.
The purpose of a C-SNP is targeted disease management. Humana provides telephonic case and care management for members managing complex conditions at no extra cost, and the plan network is built to include the specialists relevant to the condition you have.
A Humana I-SNP is for people who live in a long-term care facility, such as a skilled nursing facility, and have needed or are expected to need institutional-level care for 90 or more days. Humana calls its I-SNP product Together in Health. The model brings clinical staff directly to the resident inside the facility instead of requiring transport for routine appointments.
Unlike most Medicare Advantage plans, I-SNP enrollment is open year-round. You don't have to wait for a specific enrollment window if you meet the institutional-level-of-care requirement.
Choosing between an SNP, a standard Medicare Advantage plan, and Original Medicare comes down to your circumstances. The table below shows where SNPs differ from the alternatives most seniors weigh.
| Feature | Original Medicare | Standard Medicare Advantage | Humana Special Needs Plan |
|---|---|---|---|
| Who can enroll | Anyone with Medicare | Anyone with Medicare in the plan's service area | Only people meeting D-SNP, C-SNP, or I-SNP criteria |
| Prescription drug coverage | Requires separate Part D plan | Usually included | Always included |
| Care coordinator assigned | No | Sometimes | Yes, required by CMS |
| Model of Care | Not applicable | Not required | Required, NCQA-approved |
| Extra benefits (dental, OTC, food) | None | Varies by plan | Built around the SNP population's needs |
| Provider network | Any provider that accepts Medicare | Restricted to plan network | Restricted to plan network |
| Typical monthly plan premium | Part B premium only | Often $0 plus Part B | Often $0 plus Part B; Medicaid covers Part B for most D-SNP members |
If you qualify for an SNP, you usually get more coordinated care and more extra benefits than you would in a general Medicare Advantage plan. The trade-off is that SNP networks are smaller, and prior authorization is more common for non-routine services. Read the plan's prior authorization list before enrolling.
Most Humana SNP members pay little to nothing in plan premiums, but the underlying Medicare costs still apply. About two-thirds of Humana's Medicare Advantage portfolio, including many SNPs, features a $0 monthly plan premium. Here's what changes for 2026 and what each member type can expect.
Every Medicare Advantage member, including SNP enrollees, has to keep paying the Medicare Part B premium. For 2026, that premium is $202.90 a month, up from $185.00 in 2025. The annual Part B deductible is $283 in 2026, up from $257.
For dual eligible D-SNP members, Medicaid usually pays the Part B premium under the Qualified Medicare BeneficiaryA person who derives advantage from something, especially a trust, will, or life insurance policy. (QMB) program, so the senior pays $0 out of pocket. Members who are not dual eligible pay the $202.90 themselves unless their plan includes a Part B giveback benefit, which refunds part of the premium back to their Social Security check each month.
This is where SNPs differ from one another. Some Humana D-SNPs charge $0 copays for primary care visits, $0 copays for Tier 1 generic drugs, and $0 deductibles on covered Part D prescriptions. Across Humana's broader Medicare Advantage portfolio, 99.2% of plans offer $0 copays for Tier 1 preferred generic prescriptions, and the average in-network maximum out-of-pocket cap is around $5,951.
C-SNP and I-SNP members may face copays on certain services depending on the plan and state. Always read the Summary of Benefits and the Evidence of Coverage for the specific plan number before enrolling. Two plans with similar names in different states can have very different copay structures.
Humana reduced some over-the-counter benefits on its SNP plans for 2026, according to TD Cowen research cited by Healthcare Dive. Members renewing should compare their 2025 and 2026 Annual Notice of Changes side by side before assuming the same benefits willA legal document that states how a person's property should be managed and distributed after death. be there next year.
Enrollment in a Humana SNP has two parts: confirming you meet the eligibility rules and signing up during the right window. The steps below cover the full process from confirmation to active coverage.
CMS introduced a monthly Integrated Care Special Enrollment Period, effective January 1, 2025, that lets full-benefit dual eligible seniors switch to an integrated D-SNP in any month rather than waiting for the Annual Enrollment Period. If you already have Medicaid and a Humana D-SNP aligned with your Medicaid managed care planA personalized, detailed plan designed to address the specific needs of the elderly or disabled indi... becomes available in your area, you can move to it right away.
Humana's 2026 CMS star ratings tell a mixed story. About 20% of Humana's Medicare Advantage members are enrolled in plans rated 4 stars or higher for 2026, down from 25% in 2025 and 94% in 2024, according to disclosures the company filed with the Securities and Exchange Commission. The average rating across Humana plans is roughly 3.61, slightly below the industry-wide weighted average of 3.66.
For SNP shoppers specifically, the picture is slightly different. Roughly 54% of Humana's Medicare Advantage contracts are SNPs, and SNPs generally score better than general Medicare Advantage plans on care coordination measures because the Model of Care requirement forces structured follow-up. SNPs also tend to outperform fee-for-service Original Medicare on preventive service utilization for dual eligible populations.
In our reviews of plan structures for seniors and family caregivers, the practical takeaway is this: look at the star rating for the specific plan you're considering, not just the carrier's average. Two Humana D-SNPs in two different states can carry very different star ratings. Member satisfaction also varies by region. Humana received below-average customer satisfaction scores in 9 out of 10 markets in the 2025 J.D. Power Medicare Advantage Study.
If you want a second opinion before enrolling, every state offers a free State Health Insurance Assistance Program (SHIP) counselor who can compare plan options with you at no charge. SHIP counselors don't sell insurance and don't earn commissions, so the advice you get is editorial in nature, not promotional.
Medicare comes with a lot of acronyms. Here are the ones that matter most when you're evaluating a Humana SNP.
If you're researching SNPs on behalf of a parent, the process is more collaborative than it is for general Medicare Advantage. Eligibility rules are stricter, and the consequences of choosing the wrong plan are bigger because SNP networks tend to be narrower.
The most useful conversations start with three concrete questions. First, what does your parent already have? Original Medicare alone, a MedigapPrivate health insurance that supplements Medicare by covering co-pays, deductibles, and other expen... policy, a current Medicare Advantage plan, Medicaid, or some combination? Second, who are the doctors and specialists they don't want to lose? Third, what prescriptions are non-negotiable? Once you have those answers in writing, you can plug them into the Medicare.gov plan compare tool and screen Humana SNPs against your parents' actual care, not generic averages.
Be prepared to involve your parent in the final decision rather than making it for them. Most people in their 70s and 80s have strong opinions about their doctors and pharmacies, and switching either can feel like a loss of control, even when the new plan is technically better. The plans your parent will stay enrolled in long-term are the ones they chose with you, not the ones that were chosen for them.
If your parent has both Medicare and Medicaid, you can also help them ask the state Medicaid office whether a Humana D-SNP is aligned with their existing Medicaid managed care plan. Alignment matters because it reduces the number of phone numbers, ID cards, and paperwork stacks involved each month.
A Humana Special Needs Plan may be worth considering if you meet the eligibility rules and want Medicare Advantage coverage with built-in care coordination, prescription drug coverage, and extra benefits that Original Medicare does not usually provide. The key is matching your situation to the right SNP type: D-SNP for Medicare and Medicaid, C-SNP for a qualifying chronic condition, or I-SNP for long-term institutional care.
Before enrolling, review the Summary of Benefits for the exact Humana plan in your county, confirm your doctors and prescriptions are covered, and compare the plan’s 2026 star rating on Medicare.gov. Humana remains one of the largest Medicare Advantage carriers, but its recent quality ratings make plan-level review especially important.
For a broader look at how these plans fit into senior healthcare coverage, read Senior Strong’s guide to the top benefits of Medicare Advantage plans for seniors before comparing SNP options in your ZIP code.
You qualify for a Humana SNP if you have Medicare Parts A and B, live in the plan's service area, and meet one of three specific criteria: you have both Medicare and Medicaid (D-SNP), you have a qualifying chronic condition like diabetes or heart failure verified by your doctor (C-SNP), or you live in a long-term care facility for 90 or more days (I-SNP).
Most Humana SNPs do not pay the Part B premium directly. Dual-eligible D-SNP members usually have their Part B premium paid by Medicaid through the Qualified Medicare Beneficiary program. Some non-SNP Humana Medicare Advantage plans include a Part B giveback that refunds part of the $202.90 monthly premium, but giveback benefits are less common on SNPs.
Yes, if you meet SNP eligibility. You can switch during the Annual Enrollment Period (October 15 to December 7), during the Medicare Advantage Open Enrollment Period (January 1 to March 31), or during a Special Enrollment Period triggered by a qualifying event such as becoming dual eligible, being diagnosed with a qualifying chronic condition, or entering a long-term care facility.
It depends on which plan and where you live. Humana's overall 2026 star ratings sit below the national average, and member satisfaction varies by market. SNPs generally score better on care coordination than general Medicare Advantage plans, but you should compare the star rating, specific plan benefits, and doctor network for the exact plan you're considering on Medicare.gov before enrolling.
A D-SNP coordinates Medicare and Medicaid benefits into a single plan with one care team. Medicaid managed care alone covers only the Medicaid side of the dual-eligible member's coverage. Members who have both programs can enroll in a D-SNP to get the two coordinated, which is usually simpler than running them separately.
Only if they're in the plan's network. SNPs use restricted networks, so the first step before enrolling is checking the provider directory or calling Humana to confirm your doctors and your pharmacy are covered.
