2023 Humana Honor (PPO)

Humana Honor (PPO) H5216-234 is a 2023 Medicare Advantage Plan or Part-C by Humana available to residents in Hawaii. This plan does not provide additional prescription drug (Part-D) coverage. Humana Humana Honor (PPO) has a monthly premium of $0 and has an in-network maximum out-of-pocket limit of $7,550 (MOOP). This means that if you get sick or need a high-cost procedure the co-pays are capped once you pay $7,550 out-of-pocket. This can be an extremely nice safety net.

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 2023 Medicare Advantage Plan you are always covered for urgently needed and emergency care. Plus, you receive all the benefits of Original Medicare from Humana except hospice care. Original Medicare still provides you with hospice care if you sign up for Medicare Advantage in Hawaii.




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2023 Humana Medicare Advantage Plan Overview

Name:Humana Honor (PPO)
Plan ID:H5216 234 0
Provider:Humana
Year:2023
Type:Local PPO *
Combined Premium (C+D):$0/mo
MOOP:$7,550/yr
Similar Plan: H5216-235




What type of plan is Humana Honor (PPO)

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.

How much does Humana Honor (PPO) cost?


Part-C Premium

A monthly premium is the fee you pay to the plan in exchange for coverage. Humana charges a $0 premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.


MOOP

The maximum out-of-pocket (MOOP) is a yearly limit on your out-of-pocket costs. Humana Honor (PPO) by Humana MOOP is $7,550. Once you spend $7,550 you will pay nothing for Part A or Part B covered services. Copayments and coinsurance for Medicare approved services apply toward your out-of-pocket limit. Remember Original Medicare (Parts A and B) doesn’t have a MOOP.





2023 Summary of Benefits


The benefit information provided is a summary of what Humana Honor (PPO) covers and what you pay (such as copayments and coinsurance amounts) for certain common medical events. The Summary of Benefits from Humana helps get an idea of how much financial protection the plan is generally expected to provide for common health conditions. This section also contains information on coverage for in-network and out-of-network providers.

Wellness programs (e.g., fitness, nursing hotline)Covered



Contact lenses


In-Network Vision$0 copay
Out-of-Network Vision$0 copay



Eyeglass frames


VisionNot covered



Eyeglass lenses


VisionNot covered



Eyeglasses (frames and lenses)


Out-of-Network Vision$0 copay
In-Network Vision$0 copay



Other


VisionNot covered



Routine eye exam


Out-of-Network Vision$0 copay
In-Network Vision$0 copay



Upgrades


VisionNot covered




TransportationNot covered
In-Network Skilled Nursing Facility$0 per day for days 1 through 20
$178 per day for days 21 through 100
Out-of-Network Skilled Nursing Facility40% per stay



Occupational therapy visit


Out-of-Network Rehabilitation services40% coinsurance
In-Network Rehabilitation services20% coinsurance



Physical therapy and speech and language therapy visit


In-Network Rehabilitation services20% coinsurance
Out-of-Network Rehabilitation services40% coinsurance



Cleaning


In-Network Preventive dental0-70% coinsurance
Out-of-Network Preventive dental50-75% coinsurance



Dental x-ray(s)


In-Network Preventive dental$0 copay
Out-of-Network Preventive dental50-75% coinsurance



Fluoride treatment


In-Network Preventive dental$0 copay
Out-of-Network Preventive dental50-75% coinsurance



Oral exam


Out-of-Network Preventive dental50-75% coinsurance
In-Network Preventive dental$0 copay




Out-of-Network Preventive care$0 copay or 40% coinsurance
In-Network Preventive care$0 copay
In-Network Outpatient hospital coverage$0-350 copay or 20% coinsurance per visit
Out-of-Network Outpatient hospital coverage40% coinsurance per visit
In-Network Other health plan deductibles?No
Optional supplemental benefitsNo



Inpatient hospital - psychiatric


Out-of-Network Mental health services40% per stay
In-Network Mental health services$480 per day for days 1 through 3
$0 per day for days 4 through 90



Outpatient group therapy visit


In-Network Mental health services$30 copay
Out-of-Network Mental health services40% coinsurance



Outpatient group therapy visit with a psychiatrist


In-Network Mental health services$30 copay
Out-of-Network Mental health services40% coinsurance



Outpatient individual therapy visit


In-Network Mental health services$30 copay
Out-of-Network Mental health services40% coinsurance



Outpatient individual therapy visit with a psychiatrist


Out-of-Network Mental health services40% coinsurance
In-Network Mental health services$30 copay



Chemotherapy


In-Network Medicare Part B drugs19% coinsurance
Out-of-Network Medicare Part B drugs40% coinsurance



Other Part B drugs


In-Network Medicare Part B drugs19% coinsurance
Out-of-Network Medicare Part B drugs40% coinsurance



Diabetes supplies


Out-of-Network Medical equipment/supplies40% coinsurance per item
In-Network Medical equipment/supplies$0 copay or 10-20% coinsurance per item



Durable medical equipment (e.g., wheelchairs, oxygen)


In-Network Medical equipment/supplies13% coinsurance per item
Out-of-Network Medical equipment/supplies25% coinsurance per item



Prosthetics (e.g., braces, artificial limbs)


In-Network Medical equipment/supplies20% coinsurance per item
Out-of-Network Medical equipment/supplies30% coinsurance per item




Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)$11,300 In and Out-of-network
$7,550 In-network
In-Network Inpatient hospital coverage$480 per day for days 1 through 3
$0 per day for days 4 through 90
$0 per day for days 91 and beyond
Out-of-Network Inpatient hospital coverage40% per stay



Fitting/evaluation


Out-of-Network Hearing$0 copay
In-Network Hearing$0 copay



Hearing aids


Out-of-Network Hearing$699-999 copay
In-Network Hearing$699-999 copay



Hearing exam


In-Network Hearing$40 copay
Out-of-Network Hearing$65 copay




Health plan deductible$1,000 annual deductible
In-Network Ground ambulance20% coinsurance
Out-of-Network Ground ambulance20% coinsurance



Foot exams and treatment


In-Network Foot care (podiatry services)$40 copay
Out-of-Network Foot care (podiatry services)$65 copay



Routine foot care


Foot care (podiatry services)Not covered



Emergency


Emergency care/Urgent care$90 copay per visit (always covered)



Urgent care


Emergency care/Urgent care$20 copay per visit (always covered)



Primary


Out-of-Network Doctor visits$40 copay per visit
In-Network Doctor visits$0 copay



Specialist


Out-of-Network Doctor visits$65 copay per visit
In-Network Doctor visits$40 copay per visit



Diagnostic radiology services (e.g., MRI)


In-Network Diagnostic procedures/lab services/imaging$0-175 copay
Out-of-Network Diagnostic procedures/lab services/imaging$40 copay or 40% coinsurance



Diagnostic tests and procedures


Out-of-Network Diagnostic procedures/lab services/imaging$40-65 copay or 20-40% coinsurance
In-Network Diagnostic procedures/lab services/imaging$0-40 copay or 20% coinsurance



Lab services


Out-of-Network Diagnostic procedures/lab services/imaging$40-65 copay or 20-40% coinsurance
In-Network Diagnostic procedures/lab services/imaging$0 copay



Outpatient x-rays


In-Network Diagnostic procedures/lab services/imaging$0 copay
Out-of-Network Diagnostic procedures/lab services/imaging$40-65 copay or 20-40% coinsurance



Diagnostic services


In-Network Comprehensive dental0% coinsurance
Out-of-Network Comprehensive dental50-75% coinsurance



Endodontics


In-Network Comprehensive dental70% coinsurance
Out-of-Network Comprehensive dental50-75% coinsurance



Extractions


Out-of-Network Comprehensive dental50-75% coinsurance
In-Network Comprehensive dental50% coinsurance



Non-routine services


In-Network Comprehensive dental50% coinsurance
Out-of-Network Comprehensive dental50-75% coinsurance



Periodontics


In-Network Comprehensive dental70% coinsurance
Out-of-Network Comprehensive dental50-75% coinsurance



Prosthodontics, other oral/maxillofacial surgery, other services


In-Network Comprehensive dental70% coinsurance
Out-of-Network Comprehensive dental50-75% coinsurance



Restorative services


In-Network Comprehensive dental50-70% coinsurance
Out-of-Network Comprehensive dental50-75% coinsurance




In-Network Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?No




Humana Honor (PPO) Reviews


Is Humana Honor (PPO) a good plan? Humana Honor (PPO) received a 4.5 overall star rating from the CMS. The CMS uses a Star Rating System to measure how well Medicare Advantage and Part D plans perform. Plans are rated on a one-to-five scale, with one star representing poor performance and five stars representing excellent performance. Medicare Advantage with prescription drug (Part D) coverage (MA-PD) contracts are rated on up to 38 unique quality and performance measures. You can use the CMS star rating to compare Humana Honor Reviews among several different plans.

2022 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
Monitoring Physical Activity


Managing Chronic And Long Term Care for Older Adults

Total Rating
SNP Care Management
Medication Review
Pain Assessment
Osteoporosis Management
Diabetes Care - Eye Exam
Diabetes Care - Kidney Disease
Diabetes Care - Blood Sugar
Controlling Blood Pressure
Reducing Risk of Falling
Improving Bladder Control
Medication Reconciliation
Statin Therapy


Member Experience with H5216-234 Health Plan

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


Member Complaints and Changes in Plans Performance

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


Health Plan Customer Service Rating for Humana

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


Drug Plan Customer Service Ratings

Total Rating
Call Center, TTY, Foreign Language


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



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1-855-778-4180
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Coverage Area

(Click county or state to compare all available Advantage plans)

The availability of Medicare Advantage Plans will vary according to your region. This is why the Coverage Area matters in terms of Medicare eligibility. You will always be eligible for Original Medicare, but eligibility for Humana Honor (PPO) requires you to live in that plan’s service area. The service area is listed below:



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How much does Humana Honor (PPO) cost?

Humana charges a $0 monthly premium. A monthly premium is the fee you pay to the plan in exchange for coverage. The premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.

How much is Humana Honor (PPO) MOOP?

The maximum out-of-pocket (MOOP) is a yearly limit on your out-of-pocket costs. Humana Honor (PPO) by Humana MOOP is $7,550. Once you spend $7,550 you will pay nothing for Part A or Part B covered services.

What type of plan is Humana Honor (PPO)?

Humana Honor (PPO) is a Local PPO *. A (PPO) is a Medicare plan that has contracts with a network of preferred providers. You do not need to select a primary care physician and you do not need referrals to see other providers in the network.

Is Humana Honor (PPO) a good plan?

Humana Honor (PPO) received a 4.5 overall star rating from the CMS. The CMS uses a Star Rating System to measure how well plans perform. Plans are rated on a one-to-five scale, with one star representing poor performance and five stars representing excellent performance.



Source:CMS. Data as of Oct 1, 2022.

Last updated on

Notes: Data are subject to change as contracts are finalized. For 2023, 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 2023 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.

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*Licensed Agent Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.

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