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.

 

124 Comments

  1. on $0 premium does this amount ever go up? Can you have this plan plus the Walmart prescription plan together?

    Reply
  2. 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?

    Reply
  3. 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?

    Reply
  4. 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.

    Reply
  5. 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?

    Reply
  6. 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.

    Reply
  7. 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?

    Reply
  8. 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?

    Reply
  9. Is the Medicare Humana ppo plan a supplemental or not

    Reply
  10. If I get recommended from my doctor to go to MD Anderson for Cancer treatment will my Humana Choice cover me there?

    Reply
  11. 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.

    Reply
  12. 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

    Reply
  13. Does Humana Choice PPO cover Alternative medicine such as acupuncture?

    Reply
  14. Could you tell me if Dr. Karen King, Dallas, Texas, Buckner Blvd, is a preferred provider on the Medicare Humana Choice Plan H5415-056?
    That is all I need to know.
    Thank you.

    Reply
  15. what are the additional benefits for VIS751 HER941

    Reply

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