Humana Choice PPO Plan Details

Humana Choice PPO Plan Details

HumanaChoice PPO® is a Medicare Advantage Preferred Provider Organization (PPO) which offers additional benefits beyond original Medicare.  Humana offers a wide array of products and services in addition to your original Medicare plan.  HumanaChoice PPO® has a formed choice of hospitals, specialists and doctors for you to choose. No referral is required. You can also go to providers outside of the network but you reduce your costs when you use the in network providers.  Some plans offer Prescription drug coverage better or equal to the requirement for a Medicare Part D Plan (not available in all regions).  HumanaChoice PPO®  offers worldwide coverage for emergency care.  And features an affordable monthly plan premium for most plans.  Coverage for annual screening are also offered at no additional charge.  Below is a example of coverage of three plans offered by Humana that show in network benefits.


HumanaChoice,
PPO H5415-056
HumanaChoice,
PPO R5826-018
HumanaChoice,
PPO R5826-005
Plan Type Medicare Advantage Plan
Preferred Provider Organization(PPO)
Medicare Advantage Plan
Preferred Provider Organization(PPO)
Medicare Advantage Plan
Preferred Provider Organization(PPO)
Rx Coverage included check Humana Choice PPO Plan Details
not included check Humana Choice PPO Plan Details
included check Humana Choice PPO Plan Details
Annual Premium $468.00 $0.00 $960.00
Annual Drug Deductible $0.00 No Prescription Drug Coverage $0.00




Doctors and Hospitals

HumanaChoice,
PPO H5415-056
HumanaChoice,
PPO R5826-018
HumanaChoice,
PPO R5826-005
Annual Medical Deductible $0.00 $0.00 $0.00
Annual Plan Deductible N/A N/A N/A
Maximum Medical Out-of-Pocket $5,000.00 $4,000.00 $4,750.00
Hospital Deductible (Per Benefit Period) $0.00 $0.00 $0.00
Doctor Access
  • Option to see physicians in- or out- of the plan’s network.
  • No referrals required.
  • You pay more for out-of-network services.
  • Option to see physicians in- or out- of the plan’s network.
  • No referrals required.
  • You pay more for out-of-network services.
  • Option to see physicians in- or out- of the plan’s network.
  • No referrals required.
  • You pay more for out-of-network services.
Primary Care Doctor Copay (per visit) $15.00 $10.00 $5.00
Specialist Doctor Copay (per visit) $35.00 $30.00 $30.00
Hospital Cost (per day, per admit) $225.00 $150.00 $225.00


Additional Included Benefits

HumanaChoice,
PPO H5415-056
HumanaChoice,
PPO R5826-018
HumanaChoice,
PPO R5826-005
Life Enrichment Program included check Humana Choice PPO Plan Details included check Humana Choice PPO Plan Details included check Humana Choice PPO Plan Details
Fitness Program included check Humana Choice PPO Plan Details included check Humana Choice PPO Plan Details included check Humana Choice PPO Plan Details
24 Hour Nurse Advice Line included check Humana Choice PPO Plan Details included check Humana Choice PPO Plan Details included check Humana Choice PPO Plan Details
Alternative Medicine included check Humana Choice PPO Plan Details included check Humana Choice PPO Plan Details included check Humana Choice PPO Plan Details
Hearing Discount
not included check Humana Choice PPO Plan Details
not included check Humana Choice PPO Plan Details
not included check Humana Choice PPO Plan Details
Rx Discount included check Humana Choice PPO Plan Details
not included check Humana Choice PPO Plan Details
included check Humana Choice PPO Plan Details
Weight Management included check Humana Choice PPO Plan Details included check Humana Choice PPO Plan Details included check Humana Choice PPO Plan Details
Vision Discount included check Humana Choice PPO Plan Details included check Humana Choice PPO Plan Details



Humana Choice PPO Medicare Advantage Frequently Asked Questions

What is my premium?

The Humana Choice PPO Plan is $0-80 a month, depending on the version of the Medigap plan you choose and if you want part d prescription drug plans coverage. In addition to the Medicare Part B premium.

Do I need a referral?

No referral is required. You may use in or out-of-network providers at will. There is simply a higher cost for using non participating providers.

What is my out of pocket?

Depending on the version of plan in your area it could be $4000, $4750 or $5000 in network. To compare rates please get a Medicare supplement insurance quote.

 

43 Comments

  1. My husband & I are on the same type of plan but he got a card for Silver Sneakers and I never received one. I was wondering why I had not received one.

    Reply
    • Is his a medicare supplement plan? I get SSDI and I am 53 and get silver sneakers.

      Reply
  2. I NEED A COPY OF OUR POLICY SHOWING THAT OUR POLICY WAS EFFECTIVE 1/1/2015

    Reply
    • Please Contact Humana Directly.

      Reply
  3. I was told when I signed up for Humana Choice PPO that I could also sign up for dental coverage at a later date. How do I go about doing this?

    Reply
    • Please contact Humana directly to sign up for dental coverage.

      Reply
    • need dental coverage, how do I get it and how much does it cost?

      Reply
      • my cataract surgery was a total of $500 and I still owe on it. Why? I will call from now on first..

        I am scheduled to see specialist for graves disease, an oncologist. How much will this cost me before I schedule an appointment?

        Reply
  4. Unable to schedule Dexa Bone scan in 47408 area.

    Reply
  5. I AM A PRESENT HUMANNA CHOICE PPO MEMBER. IS CHRIST HOSPITAL OUTPATIENT FACILITY ON MOTGOMERY RD AN IN NETWORK HOSPITAL?

    Reply
  6. My mother has the humana medicare (employer PPO) plan, she is 101yrs old, is she entitled to have someone come to the house to help her with taking a shower?

    Reply
  7. is regency hospital in grand blanc michigan in the humana network ?

    Reply
  8. As an office manager, I have never been unable to speak to a rep. or find dental information on internet. This is a first. Was attempting to get dental benefits for a patient.

    Reply
  9. I’ve been trying to reach a customer service rep and there is not an option on there phone menu. This is crazy !

    Reply
  10. Does Humana Choice (PPO)pay for any medical equipment ordered by a Dr.?
    I am a case manager for a member and she is in need of a wheelchair.
    Thank you
    B.J. Ryan

    Reply
    • Humana will cover
      In-network: 80% of the cost
      Out-of-network: 70% of the cost

      Reply
  11. Is there help for people that only gets &1200.00 a month & pays &165.00 per month out of SS check.

    Reply
    • You may qualify for the low-income subsidy, that helps pay for Medicare Part D prescription drug costs.

      You may qualify if:

      Your assets are less than $13,440 (single individual) or $26,860 (married couple living together)

      Your annual income is less than $17,235 (single individual) or $23,265 (married couple living together).

      Your annual income is higher than the eligibility limit, but you support other family members who also live in the same household; or you live in Hawaii or Alaska.

      Applying online at http://www.socialsecurity.gov/extrahelp.

      Reply
    • You may be Medicare and Medicaid Dual Eligible.

      Standards:
      All States and DC $1,001 – Individual $1,348 – Couple
      Alaska: $1,247 – Individual $1,680 – Couple
      Hawaii: $1,150 – Individual $1,548 – Couple

      Asset Limits: $7,280 – Individual $10,930 – Couple

      Reply
  12. is humana choice PPO a medicare health plan with prescription drug coverage the primary insurance? Or is medicare the primary coverage?

    Reply
    • Most Medicare services are covered through the plan and aren’t paid for under Original Medicare.

      Reply
  13. Will Medicare pick up any balance that Humana Choice does not pay?

    Reply
    • No, Medicare Advantage plans are required to offer all Original Medicare coverage as a minimum.

      Reply
  14. Both my husband have Humana PPO ins. I have received twice now telephone calls from Humana wanting to speak to my husband. Both calls have be automated. I answer the questions telling them my husband was not nome. They never understand me. I am speaking on my cell phone and very clearly. They never can understand me. If Humana wants to speak to me or my husband, please have someone call directly. No automated. If that is not possible, then send an e-mail.

    Reply
  15. I was referred to an Orthooedic specialist by my primary care physician. When I went to check out after the appointment, I was told the doctor I saw, appointment scheduled by my primary care doctor, was not in the “network” and I was charged a big fee. I was also advised that I needed surgery, that Human would only cover a percentage, and only after a big deductible. This was a bad surprise! Where can I go, with my coverage to get the surgery I need? I feel betrayed, as this was a referral by my doctor who is in the system.

    Reply
  16. I can not seem to find the list of doctors that accept Humana Medicare Advantage PPO. I am trying to find a list that was put out at one time with information on different specialities and primary physicians. Please provide me with that information. Thank you.

    Reply
  17. humana is mailing more detailed plan information soon yet my coverage does not mention dental plans is why i changed medicare to better fit my needs i dont feel this is the right plan for me and its quite frustrating attempting talk to anyone besides a recording gets nowhere and i have until 4-30-16 to cancel.hopefully i recieve my humana coverage by friday so i can make a decision,seems humana isnt interested to provide a complete description of dental benefits?

    Reply
  18. I receive low income subsidy. I was told for cataract surgery in network all I would have to pay is the $45 co-payment and then the plan pays 100%. They said I have no.deductible. I want to make sure this is correct before I schedule my surgery!!

    Reply
    • Please Contact Humana Directly.

      Reply
  19. Where can I find a list of in network dentist for my Humana choice ppo plan

    Reply
  20. I have Humana Choice PPO health insurance. My husband and I are vacationing in Minnesota currently. What would happen if I landed in the Emergency Room here in MN? We are from Nevada. How much out of pocket do I have to pay? How much will my insurance cover?

    Reply
    • As long as you see a in-network provider you should still receive the same benefits. Please Check with Humana.

      Reply
  21. I cannot find a Gyn Dr in my area,in your book. Can i go to Cleveland Clinic Weston Fl or Holy Cross Hospital doctor in Ft Lauderdale, FL? and will
    Humana pay for all of the visit, after the $50 copay ?
    I have Humana PPO

    Reply
  22. what is copay for insulin syringes on Humana Choice PPO with prescription also copays for diabetic testing supplies

    Reply
  23. previous question concerns 90 day supplies on mail order for syringes and blood glucose testing supplies

    Reply

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