2015 HumanaChoice R5826-064 (Regional PPO) R5826-064 By Humana Insurance Company

HumanaChoice R5826-064 (Regional PPO) By Humana Insurance Company

HumanaChoice R5826-064 (Regional PPO) is a 2015 Medicare Advantage ("Part C" or "MA Plan") plan by Humana Insurance Company. This plan from Humana Insurance Company works with Medicare to give you significant coverage beyond Part A and Part B benefits. If you decide to sign up for HumanaChoice R5826-064 (Regional PPO) you still retain Original Medicare. But you will get additional Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from Humana Insurance Company and not Original Medicare. With Medicare Advantage plans your always covered for urgently needed and emergency care and you receive all of the benefits of Original Medicare from this plan except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.

2015 Medicare Advantage Plan Details

Plan Name:
HumanaChoice R5826-064 (Regional PPO)
Plan ID:
Provider: Humana Insurance Company
Plan Year:2015
Plan Type: Regional PPO *
Monthly Premium C+D: $0.00
MOOP: $5,900


Coverage Area for HumanaChoice R5826-064 (Regional PPO)

(Click county to compare all available plans)

State: Georgia
South Carolina
Atkinson, Bacon, Baker,
Baldwin, Banks, Barrow,
Bartow, Ben Hill, Berrien,
Bibb, Bleckley, Brantley,
Brooks, Bryan, Bulloch,
Burke, Butts, Calhoun,
Camden, Candler, Carroll,
Catoosa, Charlton, Chatham,
Chattahoochee, Chattooga, Cherokee,
Clarke, Clay, Clayton,
Clinch, Cobb, Coffee,
Colquitt, Columbia, Cook,
Coweta, Crawford, Crisp,
Dade, Dawson, DeKalb,
Decatur, Dodge, Dooly,
Dougherty, Douglas, Early,
Echols, Effingham, Elbert,
Emanuel, Evans, Fannin,
Fayette, Floyd, Forsyth,
Franklin, Fulton, Gilmer,
Glascock, Glynn, Gordon,
Grady, Greene, Gwinnett,
Habersham, Hall, Hancock,
Haralson, Harris, Hart,
Heard, Henry, Houston,
Irwin, Jackson, Jasper,
Jeff Davis, Jefferson, Jenkins,
Johnson, Jones, Lamar,
Lanier, Laurens, Lee,
Liberty, Lincoln, Long,
Lowndes, Lumpkin, Macon,
Madison, Marion, McDuffie,
McIntosh, Meriwether, Miller,
Mitchell, Monroe, Montgomery,
Morgan, Murray, Muscogee,
Newton, Oconee, Oglethorpe,
Paulding, Peach, Pickens,
Pierce, Pike, Polk,
Pulaski, Putnam, Quitman,
Rabun, Randolph, Richmond,
Rockdale, Schley, Screven,
Seminole, Spalding, Stephens,
Stewart, Sumter, Talbot,
Taliaferro, Tattnall, Taylor,
Telfair, Terrell, Thomas,
Tift, Toombs, Towns,
Treutlen, Troup, Turner,
Twiggs, Union, Upson,
Walker, Walton, Ware,
Warren, Washington, Wayne,
Webster, Wheeler, White,
Whitfield, Wilcox, Wilkes,
Wilkinson, Worth, Abbeville,
Aiken, Allendale, Anderson,
Bamberg, Barnwell, Beaufort,
Berkeley, Calhoun, Charleston,
Cherokee, Chester, Chesterfield,
Clarendon, Colleton, Darlington,
Dillon, Dorchester, Edgefield,
Fairfield, Florence, Georgetown,
Greenville, Greenwood, Hampton,
Horry, Jasper, Kershaw,
Lancaster, Laurens, Lee,
Lexington, Marion, Marlboro,
McCormick, Newberry, Oconee,
Orangeburg, Pickens, Richland,
Saluda, Spartanburg, Sumter,
Union, Williamsburg, York,

The HumanaChoice R5826-064 (Regional PPO) R5826-064 is available to residents in Georgia, South Carolina, and has a in-network Maximum Out-of-Pocket limit of $5,900 MOOP. This means that if you get sick or need a high cost procedure your co-pays are capped. If you enroll in HumanaChoice R5826-064 (Regional PPO) plan you will stop paying co-pays for the rest of the year once you pay out of pocket $5,900 This is a very nice safety net. This plan does not provide additional Medicare prescription drug (Part-D) coverage.

HumanaChoice R5826-064 (Regional PPO) is a Regional PPO *. A preferred provider organization (PPO) is a medicare plan that has created contracts with a network of "preferred" providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network. Offering you a little more flexibility overall. You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate.

Ratings for HumanaChoice R5826-064 (Regional PPO) R5826

2015 Overall Rating
Part C Summary Rating
Part D Summary Rating
Staying Healthy: Screenings, Tests, Vaccines
Managing Chronic (Long Term) Conditions
Member Experience with Health Plan
Complaints and Changes in Plans Performance
Health Plan Customer Service
Drug Plan Customer Service
Complaints and Changes in the Drug Plan
Member Experience with the Drug Plan
Drug Safety and Accuracy of Drug Pricing

Member Experience with Health Plan

Total Experience Rating
Getting Needed Care
Timely Care and Appointments
Customer Service
Health Care Quality
Rating of Health Plan
Care Coordination

Member Complaints and Changes in HumanaChoice R5826-064 (Regional PPO) Plans Performance

Total Rating
Members Leaving the Plan
Complaints about Health Plan
Health Plan Quality Improvement

Health Plan Customer Service Rating for HumanaChoice R5826-064 (Regional PPO)

Total Customer Service Rating
Timely Decisions About Appeals
Reviewing Appeals Decisions

Staying Healthy, Screening, Testing, & Vaccines

Total Preventative Rating
Breast Cancer Screening
Colorectal Cancel Screening
Cardiovascular Screening
Diabetes Care
Annual Flu Vaccine
Improving Physical
Improving Mental Health
Monitoring Physical Activity
Adult BMI Assessment

Ratings For Managing Chronic And Long Term Care

Total Rating
SNP Care Management
Medication Review
Functional Status Assessment
Pain Screening
Osteoporosis Management
Diabetes Care - Eye Exam
Diabetes Care - Kidney Disease
Diabetes Care - Blood Sugar
Diabetes Care - Cholesterol
Controlling Blood Pressure
Rheumatoid Arthritis
Improving Bladder Control
Reducing Risk of Falling
Plan - Cause Readmissions

Ratings For Member Experience with the Drug Plan

Total Rating
Rating of Drug Plan
Getting Needed Prescription Drugs

Drug Safety and Accuracy of Drug Pricing

Total Rating
MPF Price Accuracy
High Risk Medication
Diabetes Treatment
Drug Adherence for Diabetes Medications
Drug Adherence for Hypertension (RAS antagonists)
Drug Adherence for Cholesterol (Statins)

Ratings For Member Complaints and Changes in the Drug Plans Performance

Total Rating
Complaints about the Drug Plan
Members Choosing to Leave the Plan
Drug Plan Quality Improvement

HumanaChoice R5826-064 (Regional PPO) Drug Plan Customer Service ratings

Total Rating
Appeals Auto Forward
Appeals Upheld

Source: CMS.
Plans as of September 2, 2014.

Star Rating as of Oct 3, 2014.

For More Information on Ratings Please See the CMS Tech Notes Here.

Notes: Data are subject to change. All contracts for 2015 have been finalized. For 2015, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit

Includes 2015 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.

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