2023 HumanaChoice R0110-003 (Regional PPO)

HumanaChoice R0110-003 (Regional PPO) R0110-003 is a 2023 Medicare Advantage Plan or Part-C by Humana available to residents in Louisiana and Mississippi. This plan includes additional prescription drug (Part-D) coverage. Humana HumanaChoice R0110-003 (Regional PPO) has a monthly premium of $109.00 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 HumanaChoice R0110-003 (Regional 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 Louisiana or Medicare Advantage in Mississippi.




Ready to Enroll?

Enroll Here

Or Call
1-855-778-4180
Mon-Fri 8am-11pm EST




2023 Humana Medicare Advantage Plan Overview

Name:HumanaChoice R0110-003 (Regional PPO)
Plan ID:R0110 003 0
Provider:Humana
Year:2023
Type:Regional PPO
Combined Premium (C+D):$109.00/mo
Part C Premium:$61.60/mo
MOOP:$7,550/yr
Part D (Drug) Premium:$47.40/mo
Part D Supplemental Premium$0/mo
Total Part D Premium:$47.40/mo
Drug Deductible:$0/yr
Tiers with No Deductible:0
Gap Coverage:No
Benchmark:Not below the regional benchmark
Type of Medicare Health:Enhanced Alternative
Drug Benefit Type:Enhanced
Similar Plan: R0110-001




What type of plan is HumanaChoice R0110-003 (Regional PPO)

HumanaChoice R0110-003 (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.



How much does HumanaChoice R0110-003 (Regional PPO) cost?


Monthly Premium

A monthly premium is the fee you pay to the plan in exchange for coverage. Humana charges a $109.00 consolidated premium. The Part C premium is $61.60 this charge covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.


Part-D Deductible and Premium

An annual deductible is the amount you pay out-of-pocket for your prescription drugs before your plan begins to pay. HumanaChoice R0110-003 (Regional PPO) has a monthly drug premium of $47.40 and a $0 drug deductible. This Humana plan offers a $47.40 Part-D Basic Premium that is Not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0. This Premium covers any enhanced plan benefits offered by Humana above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments, and coverage of non-Part D drugs. The Part D Total Premium is $47.40. The Part D Total Premium is the addition of supplemental and basic premiums for some plans this amount can be lowered due to negative basic or supplemental premiums.


Humana Gap Coverage

In 2023 once you and your plan provider have spent $4660 on covered drugs. (Combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This Humana plan does not offer additional coverage through the gap.


Extra Help Premium Assistance

The Low Income Subsidy (LIS) Extra Helps people with Medicare pay for prescription drugs and lowers the costs of Medicare prescription drug coverage. Income limits are based on the Federal Poverty Level (FPL), which changes every year in February or March. The 2022 income limit is $1,719 ($2,309 for couples) per month. Depending on your income level you may be eligible for a full 75%, 50%, 25% premium assistance. The HumanaChoice R0110-003 (Regional PPO) medicare insurance offers a $13.50 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $22.00 for 75% low-income subsidy $30.50 for 50% and $38.90 for 25%.


Full Assistance Premium:$13.50
75% Assistance Premium:$22.00
50% Assistance Premium:$30.50
25% Assistance Premium:$38.90


MOOP

The maximum out-of-pocket (MOOP) is a yearly limit on your out-of-pocket costs. HumanaChoice R0110-003 (Regional 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.



Formulary and Drug Coverage

HumanaChoice R0110-003 (Regional PPO) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers. By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price.

Drug Tier Copay
Preferred
Pharmacy
Copay
Nonpreferred
Pharmacy
Tier 1 NA $0
Tier 2 NA $5
Tier 3 NA $47
Tier 4 NA $99
Tier 5 NA 33%

The complete HumanaChoice R0110-003 (Regional PPO) Formulary.
*Initial Coverage Phase and 30 day supply





Summary of Benefits

*2021 data this will be updated with 2023 data when available.

The benefit information provided is a summary of what HumanaChoice R0110-003 (Regional 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.




Additional Benefits


No



Comprehensive Dental


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



Deductible


$0



Diagnostic Tests and Procedures


Diagnostic radiology services (e.g., MRI) $0-225 copay
Diagnostic radiology services (e.g., MRI) $0-225 copay (Out-of-Network)
Diagnostic tests and procedures $0-100 copay
Diagnostic tests and procedures $0-225 copay (Out-of-Network)
Lab services $0-225 copay (Out-of-Network)
Lab services $0-40 copay
Outpatient x-rays $0-60 copay
Outpatient x-rays $0-225 copay (Out-of-Network)



Doctor Visits


Primary $5-35 copay per visit (Out-of-Network)
Primary $5 copay per visit
Specialist $35 copay per visit
Specialist $35-60 copay per visit (Out-of-Network)



Emergency care/Urgent Care


Emergency $90 copay per visit (always covered)
Urgent care $5-35 copay per visit (always covered)



Foot Care (podiatry services)


Foot exams and treatment $35 copay
Foot exams and treatment $35-60 copay (Out-of-Network)
Routine foot care Not covered



Ground Ambulance


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



Hearing


Fitting/evaluation $0 copay
Fitting/evaluation $0 copay (Out-of-Network)
Hearing aids $699-999 copay
Hearing aids $699-999 copay (Out-of-Network)
Hearing exam $35-60 copay (Out-of-Network)
Hearing exam $35 copay



Inpatient Hospital Coverage


$0 copay per stay
$0 copay 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) 17% coinsurance per item
Durable medical equipment (e.g., wheelchairs, oxygen) 17% coinsurance per item (Out-of-Network)
Prosthetics (e.g., braces, artificial limbs) 20% 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% coinsurance (Out-of-Network)
Other Part B drugs 20% coinsurance
Other Part B drugs 20% coinsurance (Out-of-Network)



Mental Health Services


Inpatient hospital - psychiatric $250 per stay (Out-of-Network)
Inpatient hospital - psychiatric $250 per stay
Outpatient group therapy visit $40 copay
Outpatient group therapy visit $40-50 copay (Out-of-Network)
Outpatient group therapy visit with a psychiatrist $40-50 copay (Out-of-Network)
Outpatient group therapy visit with a psychiatrist $40 copay
Outpatient individual therapy visit $40-50 copay (Out-of-Network)
Outpatient individual therapy visit $40 copay
Outpatient individual therapy visit with a psychiatrist $40-50 copay (Out-of-Network)
Outpatient individual therapy visit with a psychiatrist $40 copay



MOOP


$11,300 In and Out-of-network
$7,550 In-network



Option


No



Optional supplemental benefits


Yes



Outpatient Hospital Coverage


$50-175 copay per visit
$50-175 copay per visit (Out-of-Network)



Package #1


Deductible
Monthly Premium $15.30



Package #2


Deductible
Monthly Premium $36.90



Preventive Care


$0 copay (Out-of-Network)
$0 copay



Preventive Dental


Cleaning $0 copay
Cleaning 50-55% coinsurance (Out-of-Network)
Dental x-ray(s) $0 copay
Dental x-ray(s) 50-55% coinsurance (Out-of-Network)
Fluoride treatment Not covered
Oral exam $0 copay
Oral exam 50-55% coinsurance (Out-of-Network)



Rehabilitation Services


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



Skilled Nursing Facility


$0 per day for days 1 through 20
$178 per day for days 21 through 100 (Out-of-Network)
$0 per day for days 1 through 20
$178 per day for days 21 through 100



Transportation


Not covered



Vision


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



Wellness Programs (e.g. fitness nursing hotline)


Covered




CMS Star Ratings


Is HumanaChoice R0110-003 (Regional PPO) a good plan? HumanaChoice R0110-003 (Regional PPO) received a 4 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 HumanaChoice R0110-003 (Regional PPO) performance 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 R0110-003 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



Ready to Enroll?

Enroll Here

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




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 HumanaChoice R0110-003 (Regional PPO) requires you to live in that plan’s service area. The service area is listed below:



Go to top

How much does HumanaChoice R0110-003 (Regional PPO) cost?

Humana charges a $109.00 consolidated monthly premium. A monthly premium is the fee you pay to the plan in exchange for coverage of Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.

How much is HumanaChoice R0110-003 (Regional PPO) MOOP?

The maximum out-of-pocket (MOOP) is a yearly limit on your out-of-pocket costs. HumanaChoice R0110-003 (Regional 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 HumanaChoice R0110-003 (Regional PPO)?

HumanaChoice R0110-003 (Regional PPO) is a Regional 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 HumanaChoice R0110-003 (Regional PPO) a good plan?

HumanaChoice R0110-003 (Regional PPO) received a 4 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.

      Site Search:

*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.

Call For A licensed Sales Agent

Or Enroll Online Here

Enroll