2021 Humana Honor (PPO) H5216-128 By Humana.

Summary of Benefits for
2021 Humana Honor (PPO)


Humana Honor (PPO) H5216-128 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Humana available to residents in Texas. This plan does not provide additional Medicare prescription drug (Part-D) coverage. The Humana Honor (PPO) has a monthly premium of $0 and has an in-network Maximum Out-of-Pocket limit of $5,400 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $5,400 out of pocket. This can be a extremely nice safety net.

Humana Honor (PPO) is a Local 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.

Humana works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Humana Honor (PPO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Humana and not Original Medicare. With Medicare Advantage Plans you are always covered for urgently needed and emergency care. Plus you receive all of the benefits of Original Medicare from Humana except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.




Ready to Enroll?

Click Here

Or Call
1-855-778-4180
Mon-Fri 8am-9pm EST
Sat 9am-9pm EST




2021 Humana Medicare Advantage Plan Costs

Name:
Humana Honor (PPO)
Plan ID:
H5216-128
Provider:Humana
Year:2021
Type: Local PPO *
Monthly Premium C+D: $0
Part C Premium:
MOOP: $5,400
Similar Plan: H5216-129






2021 Humana Honor (PPO) Summary of Benefits




Additional Benefits


No



Comprehensive Dental


Diagnostic services Not covered
Endodontics Not covered
Extractions 55-75% coinsurance (Out-of-Network)
Extractions 50% coinsurance
Non-routine services Not covered
Periodontics Not covered
Prosthodontics, other oral/maxillofacial surgery, other services 70% coinsurance
Prosthodontics, other oral/maxillofacial surgery, other services 55-75% coinsurance (Out-of-Network)
Restorative services 55-75% coinsurance (Out-of-Network)
Restorative services 50-70% coinsurance



Deductible


$975 annual deductible



Diagnostic Tests and Procedures


Diagnostic radiology services (e.g., MRI) 30% coinsurance (Out-of-Network)
Diagnostic radiology services (e.g., MRI) $40-295 copay
Diagnostic tests and procedures $0-90 copay
Diagnostic tests and procedures $0 copay or 30% coinsurance (Out-of-Network)
Lab services $0-50 copay
Lab services 30% coinsurance (Out-of-Network)
Outpatient x-rays 30% coinsurance (Out-of-Network)
Outpatient x-rays $10-50 copay



Doctor Visits


Primary $10 copay per visit
Primary 30% coinsurance per visit (Out-of-Network)
Specialist 30% coinsurance per visit (Out-of-Network)
Specialist $40 copay per visit



Emergency care/Urgent Care


Emergency $90 copay per visit (always covered)
Urgent care $10-40 copay or 30% coinsurance per visit (always covered)



Foot Care (podiatry services)


Foot exams and treatment 30% coinsurance (Out-of-Network)
Foot exams and treatment $40 copay
Routine foot care Not covered



Ground Ambulance


$265 copay (Out-of-Network)
$265 copay



Hearing


Fitting/evaluation $0 copay (Out-of-Network)
Fitting/evaluation $0 copay
Hearing aids $199-499 copay
Hearing aids $199-499 copay (Out-of-Network)
Hearing exam 30% coinsurance (Out-of-Network)
Hearing exam $40 copay



Inpatient Hospital Coverage


$295 per day for days 1 through 5
$0 per day for days 6 through 90
$0 per day for days 91 and beyond
30% per stay (Out-of-Network)



Medical Equipment/Supplies


Diabetes supplies $0 copay or 10-20% coinsurance per item
Diabetes supplies 20% coinsurance per item (Out-of-Network)
Durable medical equipment (e.g., wheelchairs, oxygen) 15% coinsurance per item
Durable medical equipment (e.g., wheelchairs, oxygen) 20% coinsurance per item (Out-of-Network)
Prosthetics (e.g., braces, artificial limbs) 15% coinsurance per item
Prosthetics (e.g., braces, artificial limbs) 20% coinsurance per item (Out-of-Network)



Medicare Part B Drugs


Chemotherapy 20% coinsurance
Chemotherapy 20-30% coinsurance (Out-of-Network)
Other Part B drugs 20-30% coinsurance (Out-of-Network)
Other Part B drugs 20% coinsurance



Mental Health Services


Inpatient hospital - psychiatric 30% per stay (Out-of-Network)
Inpatient hospital - psychiatric $295 per day for days 1 through 5
$0 per day for days 6 through 90
Outpatient group therapy visit 30% coinsurance (Out-of-Network)
Outpatient group therapy visit $40 copay
Outpatient group therapy visit with a psychiatrist $40 copay
Outpatient group therapy visit with a psychiatrist 30% coinsurance (Out-of-Network)
Outpatient individual therapy visit $40 copay
Outpatient individual therapy visit 30% coinsurance (Out-of-Network)
Outpatient individual therapy visit with a psychiatrist 30% coinsurance (Out-of-Network)
Outpatient individual therapy visit with a psychiatrist $40 copay



MOOP


$6,700 In and Out-of-network
$5,400 In-network



Option


No



Optional supplemental benefits


No



Outpatient Hospital Coverage


$40-295 copay per visit
30% coinsurance per visit (Out-of-Network)



Preventive Care


$0 copay
$0 copay or 30% coinsurance (Out-of-Network)



Preventive Dental


Cleaning $0 copay
Cleaning 50% coinsurance (Out-of-Network)
Dental x-ray(s) $0 copay
Dental x-ray(s) 50% coinsurance (Out-of-Network)
Fluoride treatment Not covered
Oral exam 50% coinsurance (Out-of-Network)
Oral exam $0 copay



Rehabilitation Services


Occupational therapy visit $25 copay
Occupational therapy visit 30% coinsurance (Out-of-Network)
Physical therapy and speech and language therapy visit $25 copay
Physical therapy and speech and language therapy visit 30% coinsurance (Out-of-Network)



Skilled Nursing Facility


30% per stay (Out-of-Network)
$0 per day for days 1 through 20
$172 per day for days 21 through 100



Transportation


50% coinsurance (Out-of-Network)
$0 copay



Vision


Contact lenses $0 copay (Out-of-Network)
Contact lenses $0 copay
Eyeglass frames Not covered
Eyeglass lenses Not covered
Eyeglasses (frames and lenses) $0 copay
Eyeglasses (frames and lenses) $0 copay (Out-of-Network)
Other Not covered
Routine eye exam $0 copay
Routine eye exam $0 copay (Out-of-Network)
Upgrades Not covered



Wellness Programs (e.g. fitness nursing hotline)


Covered




Reviews for Humana Honor (PPO) H5216



2019 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


Staying Healthy, Screening, Testing, & Vaccines

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


Managing Chronic And Long Term Care for Older Adults

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
Rheumatoid Arthritis
Reducing Risk of Falling
Improving Bladder Control
Medication Reconciliation
Statin Therapy


Member Experience with Health Plan

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


Member Complaints and Changes in Humana Honor (PPO) Plans Performance

Total Rating
Complaints about Health Plan
Members Leaving the Plan
Health Plan Quality Improvement
Timely Decisions About Appeals


Health Plan Customer Service Rating for Humana Honor (PPO)

Total Customer Service Rating
Reviewing Appeals Decisions
Call Center, TTY, Foreign Language


Humana Honor (PPO) Drug Plan Customer Service Ratings

Total Rating
Call Center, TTY, Foreign Language
Appeals Auto
Appeals Upheld


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


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
Drug Adherence for Diabetes Medications
Drug Adherence for Hypertension (RAS antagonists)
Drug Adherence for Cholesterol (Statins)
MTM Program Completion Rate for CMR
Statin with Diabetes



Ready to Enroll?

Click Here

Or Call
1-855-778-4180
Mon-Sat 8am-11pm EST
Sun 9am-6pm EST




Coverage Area for Humana Honor (PPO)

(Click county to compare all available Advantage plans)

State: Texas
County:


Go to top

Source: CMS.
Data as of September 9, 2020.
Notes: Data are subject to change as contracts are finalized. For 2021, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit. Includes 2021 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.

Call For A licensed Sales Agent


Or Enroll Online Here

Call to Enroll!