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.

 

86 Comments

  1. I have Humana Choice Florida (PPO) and need to know what my Dental Benefits are. Please outline for me. Also, please send me a benefit booklet for 2019.

    Reply
  2. I have Humana Choice PPO. I understand the plan now includes Dental. A list of dentists on the plan has not been provided as well as a list of doctors on the plan. I called today and was told in about seven to ten days this information would be mailed to me. I thought I would also check on line and all I found were plans I could purchase. Information should be available to members when the cards are mailed for the year.

    Reply
  3. I have medicare advantage in Virginia, my question is: I want to stay in my home. Is there any help with the cost? I need someone to help with my every day medical needs (I have mobility issues and seizures)does this fall under caregiver and what dues it pay, and hat documents do I turn to get this started? I’ve been looking at caregivers advertising on care .com

    Reply
  4. My new Humana Card had Dental included. I would like to know what coverage is with it.

    Reply
  5. I have Humana Advantage Medicare PPO insurance. However, for impt medical reasons, my specialist drs said I need a temporal ear lobe L and R CT scan. Also I need a colonoscopy. I barely have $20.0O in bank, so how am I supposed to pay the copay as well as added costs?

    Reply
  6. In Texas, They are telling me I can’t buy a supplemental policy plan G unless I drop my Humana Medicare Coice PPO policy. Is this true and why?

    Reply
  7. I have Humana choice ppo thru Medicare. Just recently got approved for medicaid and would like to know how Humana will interact with the medicaid health plan?

    Reply
  8. I have Humana ppo supplement and medicare A and B. What is the cost of stress test and eco

    Reply
  9. What is covered with the dental portion?

    Reply
  10. Is prior authorization required for MRI’s and CT scans?

    Reply
    • I have Medicare A&B and Humanachoice(PPO)…My urologist wrote a prescription for an MRI… I called and talked to Humana and the person told me it would be 180.00 out of pocket, or copay?Local service Fairfax,MRI Center,Va.Says they are out of network and I would have to pay 1800-2000… Any body else do this in my area?in -network?

      Reply
  11. I am enrolled in HumanaChoice Florida PPO and am paying additional $12.99 for dental but never received a booklet to show coverages or physicians. Please send me proper information. Thank you

    Reply
  12. Are hearing tests and hearing aides covered

    Reply
  13. I have Humana hmo since June 19, 2019. I need to switch to Humana ppo, how do I do this. I am on Medicare.

    Reply
  14. I have Humana PPO Choice in Florida. My Medicare Advantage Plan has an in-network Primary Care Visit Copay of $5 and a Specialist Visit Copay of $35. Is the $5 copay valid for any in-network internal medicine or family practice doctor I chose to see, which could vary throughout the year, or only for the PCP I have named? In other words, if I see an internist different from my named PCP, is that internist now considered a specialist and am I billed $35 copay?

    Reply

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