About Humana Coverage in King Of Prussia
Humana operates 14 distinct plans in King Of Prussia, PA, with a combined in-network roster of 256 doctors across 38 medical specialties. Among the five largest insurers we track in King Of Prussia, Humana ranks #5 by provider count, the leader is Aetna with 788 in-network doctors. Use this page to confirm a specific provider is in-network, understand which Humana plans have the widest reach in King Of Prussia, and compare coverage against other major insurers before scheduling care.
Humana sells PPO, HMO, SNP, PFFS plan types in King Of Prussia. A PPO (Preferred Provider Organization) lets you see any provider without a referral; out-of-network care is covered but you pay a higher share. An HMO (Health Maintenance Organization) requires you to pick a primary-care doctor and get referrals for most specialist care, usually in exchange for lower premiums. An EPO (Exclusive Provider Organization) is in-network only, like an HMO, but skips the referral requirement. A POS (Point of Service) plan blends HMO-style in-network with PPO-style out-of-network options. Your plan name is on your member ID card.
Humana is a Medicare Advantage carrier in King Of Prussia with 13 plans available to seniors, listed below with star ratings and premiums. Humana does not currently sell ACA marketplace plans in PA; commercial coverage shown above comes through employer groups.
Data is sourced from the federally-mandated CMS Transparency in Coverage filings that every insurer must publish monthly. Medicare Advantage plans come from the CMS MA Landscape File. Last refreshed May 29, 2026. Networks change between filings, so even when a doctor appears here we recommend calling their office with your member ID to confirm current network status before your visit.
Plan Type Mix in King Of Prussia
Humana organizes its King Of Prussia network into several plan types, each with different rules about which doctors you can see and what referrals you need. The bars below show the unique-provider share of the 256-doctor network that offers plans of each type.
A high PPO share means most Humana doctors in King Of Prussia accept the insurer’s broader preferred-provider plans. these give you maximum choice and don’t require referrals to specialists. A high HMO share signals a tighter gatekeeper model: lower premiums but you usually need your primary-care doctor to refer you before a specialist will bill. EPO and POS bars sit between those two on both flexibility and cost.
Because individual doctors typically participate in multiple Humana plan types at once, these percentages don’t sum to 100%. the same provider can appear as both PPO and OAP coverage. What the chart tells you is which plan categories have meaningful depth in King Of Prussia.
Percentages don’t sum to 100% because most doctors participate in several plan types simultaneously.
Humana Plans for Ophthalmologists in King Of Prussia
Network-level provider counts for ophthalmologists accepting Humana in King Of Prussia. Each row is a network in Humana’s federal filing. your specific plan maps to one of these.
Medicare PPO
PPO
8
National Employer HMO-Home
HMO
8
Medicare PPO/Employer PPO Plus
PPO
8
Natl Medicare HMO/SNP-Travel
HMO
8
HumanaGoldChoice Ntwk PFFS
PFFS
8
Gold Plus HMO PA
HMO
7
Gold Plus HMO- New Jersey
HMO
7
Gold Plus Dual Eligible SNP
SNP
6
EyeMed
UNKNOWN
3
Humana USAA Honor Giveback HMO
HMO
1
Gold Plus DSNP H5619 KY
SNP
1
Gold Plus DSNP H1036 KY
SNP
1
Humana Medicare Advantage Plans in King Of Prussia
13 Humana Medicare Advantage plans available to seniors in King Of Prussia. Each plan combines Medicare Parts A, B and usually D (prescription drugs) into one product, with star ratings and monthly premiums shown.
Star ratings (1-5) reflect overall plan quality measured by CMS. a 4-star plan generally indicates above-average member experience and care coordination. Premiums shown are the monthly cost on top of the standard Medicare Part B premium.
Source: CMS Medicare Advantage Landscape File. Star ratings reflect overall plan performance per CMS quality measures. Premiums shown are monthly Part C+D consolidated.
Physician Experience in Humana’s King Of Prussia Network
Years since medical school graduation is a reasonable proxy for experience, though it doesn’t capture fellowship training, subspecialty certifications, or years spent in specific clinical settings. For Humana’s King Of Prussia network the breakdown below gives a quick sense of whether you’re picking from a predominantly early-career roster or one weighted toward veteran practitioners.
A network heavy on early-career doctors (0–5 years) often means lower wait times for new patients and exposure to the latest training, while veteran providers (30+ years) typically bring deeper pattern recognition for unusual presentations. A balanced distribution. roughly one-quarter in each bucket. is a healthy signal that the insurer has depth at every career stage, not just new graduates filling out its directory.
Telehealth Coverage in King Of Prussia
36 of 256 Humana in-network providers (14%) offer telehealth visits in King Of Prussia. Video appointments are typically covered for follow-ups, medication refills and adjustments, mental-health sessions, dermatology triage, and low-acuity primary care.
Availability and reimbursement still vary by state regulation and specific plan. Psychiatry, behavioral-health, and primary-care telehealth is near-universal at this point; procedural specialties (cardiology, orthopedics) typically offer video visits for pre-op consults and post-op follow-up but not initial diagnostic visits. Call the office with your Humana member ID to confirm your plan covers the visit type you need.
Top specialties offering telehealth in King Of Prussia
Top Hospitals Serving Humana Patients in King Of Prussia
Hospitals with the most Humana-network physicians practicing there. Large affiliation counts indicate that Humana has a durable relationship with the facility, which typically means smoother prior-authorizations for admissions, lab work, and follow-up care coordinated under one roof.
Hospital coverage is a separate contract from physician coverage. your Humana plan may cover a doctor who admits at Hospital X but classify the hospital itself as out-of-network, leaving you with a surprise facility bill. Before scheduling anything inpatient or procedural, call both the doctor’s office and the hospital billing line with your member ID to confirm both sides are in-network for the specific plan you hold.
Paoli Hospital
Paoli, PA
Hospital Of Univ Of Pennsylvania
Philadelphia, PA
Bryn Mawr Hospital
Bryn Mawr, PA
Jefferson Einstein Montgomery Hospital
East Norriton, PA
Main Line Hospital Lankenau
Wynnewood, PA
Chester County Hospital
West Chester, PA
Coverage Compared in King Of Prussia
Side-by-side provider counts for the five largest commercial and government insurers tracked in King Of Prussia. These numbers show raw network breadth. they don’t adjust for quality, specialty mix, or your specific plan’s tier structure, but they’re a useful first filter when choosing a carrier at open enrollment.
If Humana’s provider count looks limited for your needs, the alternatives below may fit better. Click any row to open that insurer’s King Of Prussia provider list with the same filters, plan breakdown, and hospital affiliations that you’re seeing here.
Nearby Cities with Humana Coverage
Cities closest to King Of Prussia where Humana has an in-network provider base of meaningful size. Useful if you’re willing to drive a short distance for a hard-to-find specialist, have two offices to choose between, or are planning a move inside the region.
The mileage figures are straight-line distances computed from average practice-address coordinates, not drive-time. Counts reflect each nearby city’s Humana network size. a small count doesn’t mean no coverage, just that your in-King Of Prussia options are likely more plentiful.
Frequently Asked Questions
Common questions about Humana coverage in King Of Prussia
How do I find an Humana in-network doctor in King Of Prussia, PA?
Humana has 256 in-network providers across 38 medical specialties in King Of Prussia. This list is compiled from federally-mandated CMS Transparency in Coverage filings, last verified May 29, 2026. Filter by specialty, plan type, gender, telehealth or experience above to narrow your search, then click any provider for full credentials and contact details. Always confirm coverage with your specific plan before scheduling.
What Humana plan types are available in King Of Prussia?
Humana sells 4 distinct plan types in King Of Prussia: PPO (238 doctors), HMO (211 doctors), SNP (195 doctors), PFFS (191 doctors). PPO plans give you the broadest provider choice without referrals; HMO plans require a primary-care referral but typically have lower premiums; EPO plans skip the referral but stay in-network only; POS plans blend HMO in-network rules with PPO out-of-network options. Choose by reading what's printed on your member ID card and matching it to one of the rows in the Plans section above.
Does Humana offer Medicare Advantage in King Of Prussia?
Yes. Humana offers 13 Medicare Advantage plans in King Of Prussia for 2026, with plan types including PPO, Regional PPO, PFFS, HMO. The average CMS star rating across these plans is 3.5 of 5. Medicare Advantage (Part C) bundles Parts A and B with usually Part D prescription drug coverage, often adding dental, vision, and wellness benefits. Enrollment is open during the annual election period each fall.
What's the highest-rated Humana Medicare Advantage plan in King Of Prussia?
HumanaChoice Giveback H5216-116 (PPO) (PPO) holds Humana's top CMS star rating in King Of Prussia at 3.5 of 5. Star ratings reflect overall plan quality based on member experience, customer service, drug pricing, and clinical care measures. Plans rated 4 or higher generally indicate above-average performance.
Are there $0 premium Humana Medicare Advantage plans in King Of Prussia?
Yes. 5 of Humana's 13 Medicare Advantage plans in King Of Prussia carry a $0 monthly premium for 2026. Note that $0 premium plans still require you to pay the standard Medicare Part B premium each month, plus copays and deductibles when you use care. Compare each plan's MOOP (maximum out-of-pocket) limit to understand worst-case annual cost.
Which hospitals in King Of Prussia accept Humana?
Hospitals where Humana doctors most commonly practice in King Of Prussia include PAOLI HOSPITAL, HOSPITAL OF UNIV OF PENNSYLVANIA, BRYN MAWR HOSPITAL, JEFFERSON EINSTEIN MONTGOMERY HOSPITAL. This is inferred from physician affiliations rather than direct insurer-hospital contracts, so confirm hospital network status separately with both your Humana plan and the hospital's billing department before scheduling any inpatient or surgical procedure. Even when a doctor is in-network, the hospital where they admit may not be.
Which medical specialties have the most Humana providers in King Of Prussia?
Humana's King Of Prussia network is largest in Nurse Practitioner (26), Dentist (25), Optometry (20). Primary care, behavioral health, and physical therapy tend to dominate insurer networks because high patient volumes drive deeper provider contracts. Surgical sub-specialties typically have narrower networks. Click any specialty in the section above to see a filtered list of those in-network providers.
How does Humana compare to other insurers in King Of Prussia?
Humana ranks #5 of 5 major insurers tracked in King Of Prussia by provider count, with 256 doctors. Aetna leads at 788 providers. Larger network size means more provider choice but doesn't guarantee that your specific doctor is in-network with any insurer. The Coverage Compared section above shows side-by-side counts for the top five carriers in King Of Prussia.
How do I verify a doctor is in-network with Humana?
Three steps: first match the doctor's name against this list, second call the provider's office with your member ID to confirm they currently accept your specific Humana plan, and third check Humana's own member portal for the most authoritative real-time status. Networks change between monthly federal filings; our data was last refreshed May 29, 2026.
What if my doctor isn't listed here?
This list reflects Humana's submitted network data as of the last federal filing on May 29, 2026. Doctors join and leave networks between filings, so a current in-network provider may be missing if they joined recently. Call the doctor's office to ask whether they currently accept Humana, then check Humana's own member portal for confirmation.
When was this Humana data last updated?
The Humana King Of Prussia provider list was last refreshed May 29, 2026. Doctor and network data come from the federally-mandated CMS Transparency in Coverage filings that every insurer must publish monthly. Medicare Advantage plans come from the CMS MA Landscape File. Refresh cadence: monthly for provider data, annually for marketplace and Medicare plans.
Related healthcare resources
Patient resources for King Of Prussia Humana members.
Common health topics
Common medications
Common procedure costs
Data freshness
Last verified May 29, 2026 · Source: CMS Transparency in Coverage federal filings · Refresh cadence: monthly