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 |  |
 |
|
| 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 |
|
|
|
| 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 | |
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|
| Fitness Program | |
|
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| 24 Hour Nurse Advice Line | |
|
|
| Alternative Medicine | |
|
|
| Hearing Discount | |
|
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| Rx Discount | |
|
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| Weight Management | |
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| Vision Discount | |
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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.
My husband & I are on the same type of plan but he got a card for Silver Sneakers and I never received one. I was wondering why I had not received one.
Is his a medicare supplement plan? I get SSDI and I am 53 and get silver sneakers.
Who are the dentist i can use. I have the silver sneakersccard
How do i know if i have the plan Silver Sneakers
I NEED A COPY OF OUR POLICY SHOWING THAT OUR POLICY WAS EFFECTIVE 1/1/2015
Please Contact Humana Directly.
I was told when I signed up for Humana Choice PPO that I could also sign up for dental coverage at a later date. How do I go about doing this?
Please contact Humana directly to sign up for dental coverage.
need dental coverage, how do I get it and how much does it cost?
my cataract surgery was a total of $500 and I still owe on it. Why? I will call from now on first..
I am scheduled to see specialist for graves disease, an oncologist. How much will this cost me before I schedule an appointment?
Will my Humana cover cataract surgery? If so how much do they cover? My zip code is 25401
I need to get labs done. Where do I go that is covered?
Unable to schedule Dexa Bone scan in 47408 area.
I AM A PRESENT HUMANNA CHOICE PPO MEMBER. IS CHRIST HOSPITAL OUTPATIENT FACILITY ON MOTGOMERY RD AN IN NETWORK HOSPITAL?
Sorry we do not have a provider list. You can see one at Humana’s website here:
https://www.humana.com/finder/medical?pageId=027456a8780a4daabc5fce8aa4a0bd04
My mother has the humana medicare (employer PPO) plan, she is 101yrs old, is she entitled to have someone come to the house to help her with taking a shower?
is regency hospital in grand blanc michigan in the humana network ?
Sorry we do not have a provider list. You can see one at Humana’s website here:
https://www.humana.com/finder/medical?pageId=027456a8780a4daabc5fce8aa4a0bd04
As an office manager, I have never been unable to speak to a rep. or find dental information on internet. This is a first. Was attempting to get dental benefits for a patient.
https://www.humana.com/provider/dentists/
How do I sign up for more dental coverage including dentures?
I’ve been trying to reach a customer service rep and there is not an option on there phone menu. This is crazy !
Sign in to MyHumana (https://www.humana.com/logon) and send them an email.
Does Humana Choice (PPO)pay for any medical equipment ordered by a Dr.?
I am a case manager for a member and she is in need of a wheelchair.
Thank you
B.J. Ryan
Humana will cover
In-network: 80% of the cost
Out-of-network: 70% of the cost
Is there help for people that only gets &1200.00 a month & pays &165.00 per month out of SS check.
You may qualify for the low-income subsidy, that helps pay for Medicare Part D prescription drug costs.
You may qualify if:
Your assets are less than $13,440 (single individual) or $26,860 (married couple living together)
Your annual income is less than $17,235 (single individual) or $23,265 (married couple living together).
Your annual income is higher than the eligibility limit, but you support other family members who also live in the same household; or you live in Hawaii or Alaska.
Applying online at http://www.socialsecurity.gov/extrahelp.
You may be Medicare and Medicaid Dual Eligible.
Standards:
All States and DC $1,001 – Individual $1,348 – Couple
Alaska: $1,247 – Individual $1,680 – Couple
Hawaii: $1,150 – Individual $1,548 – Couple
Asset Limits: $7,280 – Individual $10,930 – Couple
is humana choice PPO a medicare health plan with prescription drug coverage the primary insurance? Or is medicare the primary coverage?
Most Medicare services are covered through the plan and aren’t paid for under Original Medicare.
Will Medicare pick up any balance that Humana Choice does not pay?
No, Medicare Advantage plans are required to offer all Original Medicare coverage as a minimum.
Both my husband have Humana PPO ins. I have received twice now telephone calls from Humana wanting to speak to my husband. Both calls have be automated. I answer the questions telling them my husband was not nome. They never understand me. I am speaking on my cell phone and very clearly. They never can understand me. If Humana wants to speak to me or my husband, please have someone call directly. No automated. If that is not possible, then send an e-mail.
I was referred to an Orthooedic specialist by my primary care physician. When I went to check out after the appointment, I was told the doctor I saw, appointment scheduled by my primary care doctor, was not in the “network” and I was charged a big fee. I was also advised that I needed surgery, that Human would only cover a percentage, and only after a big deductible. This was a bad surprise! Where can I go, with my coverage to get the surgery I need? I feel betrayed, as this was a referral by my doctor who is in the system.
I can not seem to find the list of doctors that accept Humana Medicare Advantage PPO. I am trying to find a list that was put out at one time with information on different specialities and primary physicians. Please provide me with that information. Thank you.
Sign in to MyHumana (https://www.humana.com/logon)
humana is mailing more detailed plan information soon yet my coverage does not mention dental plans is why i changed medicare to better fit my needs i dont feel this is the right plan for me and its quite frustrating attempting talk to anyone besides a recording gets nowhere and i have until 4-30-16 to cancel.hopefully i recieve my humana coverage by friday so i can make a decision,seems humana isnt interested to provide a complete description of dental benefits?
I receive low income subsidy. I was told for cataract surgery in network all I would have to pay is the $45 co-payment and then the plan pays 100%. They said I have no.deductible. I want to make sure this is correct before I schedule my surgery!!
Please Contact Humana Directly.
Where can I find a list of in network dentist for my Humana choice ppo plan
https://www.humana.com/provider/dentists/
I have Humana Choice PPO health insurance. My husband and I are vacationing in Minnesota currently. What would happen if I landed in the Emergency Room here in MN? We are from Nevada. How much out of pocket do I have to pay? How much will my insurance cover?
As long as you see a in-network provider you should still receive the same benefits. Please Check with Humana.
I cannot find a Gyn Dr in my area,in your book. Can i go to Cleveland Clinic Weston Fl or Holy Cross Hospital doctor in Ft Lauderdale, FL? and will
Humana pay for all of the visit, after the $50 copay ?
I have Humana PPO
You can look for one at Humana’s website here:
https://www.humana.com/finder/medical/
what is copay for insulin syringes on Humana Choice PPO with prescription also copays for diabetic testing supplies
previous question concerns 90 day supplies on mail order for syringes and blood glucose testing supplies
Do you offer discount memberships to fitness centers for Humana PPO members
I have not received my new card,when were they mailed.
Tier 1 or tier 2 medication to treat diabetic neuropothy on humana choice ppo formulary
If you order thru Humana pharmacy it’s zero copay on 90 day supplies
Why did my Medicare premium go up to $267.90 in 2017
that was over $150.00 increase?
Medicare Premium did not go up to what you posted. It is 134.00 for 2018
Will Humana Choice cover orthotics and durable medical equipment? Or does the coverage for the equipment or is it covered by Medicare only?
My husband has humana gold plus hmo. He is having dental problems and may also need a new lower denture. He called to find out what type of dental is covered and could not get help . Also for vision what is he covered for under this plan?
Are the $424 sunglasses provided by the hospital after combined cataract and cornea transplant surgery for eye protection reimbursed by Medicare?
on $0 premium does this amount ever go up? Can you have this plan plus the Walmart prescription plan together?
I have a Humanachoice ( regional,PPo)H56074368 I may need Cataract surgery. how much will I have to pay in net-work and or out of network? How do I find if the doctor I am supposed to see is in network?
I recently had to go out of network to see a doctor that specialized in eye infections. Where do I send my receipt to be reimbursed for my exam?
as a US veteran and going mainly to the VA for medical help I have to ask why Humana Choice PPO doesn’t cover any of the cost for services not covered by my service.
I am a Humana Choice PPO member in Illinois. I am considering changing my residency to Florida. I plan to stay with Humana Choice PPO in Florida. What are the main differences between the Illinois and Florida plan coverages?
I am disabled and receiving Social Security benefits each month, and I have Medicare coverage in which $110 is deducted from my monthly benefit. To help with prescription costs, I enrolled in a HumanaChoice (PPO) to save money, and was told the HumanaChoice policy will take the place of Medicare. My question is, can I drop the Medicare from my disability benefit to avoid the $110/mo. deduction since I am no longer using Medicare? I have been to the Social Security website and can not find any reference to this subject, and trying to get someone on the phone is nearly impossible. Thank You.
I live part of the year in Europe. What coverage do I have while in Europe? Is this considered travel insurance or something else and what does Humana have to cover me?
I find that most Drs in NC will take Humana ChoiceCare but only a few will take Choice. What is the difference and can i can my Humana to Choicecare without losing time of benefits?
Is the Medicare Humana ppo plan a supplemental or not
If I get recommended from my doctor to go to MD Anderson for Cancer treatment will my Humana Choice cover me there?
I am a self cath patient. how many catheters am I allow to use per day that humana pays for? I ask this because I am told by my doctor that I am not reliving my urinary tract often enough an it is part of the reason I am going through renal failure. Please help ..I am dying a slow painful death.
You cannot drop the amount taken from Social Security check, as Humana gets that, and in my brother’s case, an additional $97.00 a month. Then they take over. He has a yearly deductible. I think $1000.00. $15.00 co pay at doctors