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.

 

123 Comments

  1. I will be getting Choice PPO in Md in 2022. Does Bisoprolol get covered under my new plan?

    Reply
  2. We have humana choice PPO….are shingle shots covered? We were told they were and paid our $35……….now we’re being billed for balance. Can’t get a straight answer from anyone

    Reply
  3. The thought of fighting to get approved for a procedure alone makes me glad we did not choose the advantage plan. It’s so nice not to worry about it. I wanted to bring up Good RX, a prescription app. We pay for the cheapest part D drug plan. We hardly ever use it. We have our pharmacist compare prices with our Part D and with Good RX. Most often Good RX is cheaper, by a lot!

    Reply
  4. I heard straight Medicare is best

    Reply
  5. The last thing I want is to be denied seeing whatever doctor I want to or go to any hospital I want to. That should always be my decision and not some board of directors of a multi-billion-dollar insurance company. My mother was on an advantage plan and every negative thing you said about it is true.

    Reply
  6. Medicare advantage plans are great if you get the right one. I have one that I don’t pay any premiums on Medicare pays the premium and that’s it. I love it! I have had no trouble with seeing any doctors that I like or finding one that I like anyway.

    Reply
  7. Why can I get a list of plan providers?

    Reply

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