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. If I purchase a HumanaChoice Regional PPO where I currently live, will the coverage be available when I’m in the South during Winter? Will it still be considered in-network?

    Reply
    • I have Humana choice Ppo. Can I use this anywhere like in other states while I’m there

      Reply
      • My wife has a few conditions. She is being treated for. My health rep keeps telling me we should t change our current coverage with another company because the new company would require a physical. Your plans look attractive to us.

        Reply
        • Does humanachoice Ppo (H45691176) cover part C

          Reply
          • I am signed up for humane choice program. Does this plan include silver sneakers?

        • Need information on copays etc . Please advise thanks.
          Also, why are none of these questions answered??

          Reply
      • Im ready to order my hearing aids

        Reply
    • I have just applied for Humana Medicare advantage PPO in New York City county.My question is if I go to San Bernardino county,California will my Humana Medicare advantage PPO accept by the doctor there in case I have unforeseen sickness?

      Reply
  2. Health insurance has become far to complex but certainly not competitive. One can spend more time trying to find a suitable plan than the time is worth. Better to go without insurance and just pay as you go than to waste hours and hours trying to find the right plan. Much of this nonsense is due to the ACA. It has good points and some very bad points.

    Who the hell ins the insurance industry gives a damn about the patient as long as they get their fat bonus every year.

    Reply
    • Pay as you go? Are you insane? You could end up in a hospital overnight with a surgery that costs 80 THOUSAND bucks, plus anesthetic costs, plus pathology and so forth. If you have HumanaChoicePPO it would cost you $250. That’s IT for ALL of it. Mine is the on that starts with 5216 which is not shown on here. 0 monthly premium. 5 bucks PCP, 40 bucks specialist, 90 bucks emergency room and $250 for OUT patient surgery, which means you can be in the hospital 23 hours after the surgery is done (overnight).

      Reply
      • Unsure what plan you are referring to. Please let me know as I have Humana and my out of pocket fees are over the top. Actually Humana perpetuate s neglect of people care due to the large out of pocket hidden fees etc..

        Reply
  3. How does Humana choice PPO pay on surgery?

    Reply
    • I’d like to know why a discount isn’t included in my Humanachoice Florida (PPO). I have never had a health insurance plan that didn’t offer some sort of a discount for hearing aids. When people become Medicare age, many need hearing aids, including myself. I have to be honest, I’m going to search for a possible advantage plan that may offer one.

      Reply
    • Excellent question ⁉️ No one answered tho.

      Reply
  4. How can I find out which nursing homes are in your network in my area

    Reply
  5. Is Humana helps with Matrix Medical? Need info. I have Humana started last Nov 2019 but have to get secondary.

    Reply
  6. Does my PPO cover costs associated with acupuncture?

    Reply
  7. I have Medicaid and Medicare and i have begged to know my benefits just listed out without a bunch of mumble,jumble. Impossible

    Reply
    • The only way to get straight answers is directly from a agent I have had the same problem for years and years

      Reply
  8. Asking on behalf of my husband: His plan is Humana Choice PPO. What Part (A, B, or C) refers to his Medicare Part?

    Reply
  9. How do I determine what providers in my area are in network?

    Reply
    • I have Humana Choice PPO, I need to see a neurologist and can’t find a list of Providers. I’m located in Conroe, Texas but could go to The Woodlands, Tx.

      Reply
  10. Does this insurance pay for the New Shingles shots?

    Reply
  11. I have humanachoice(ppo)how do I file it online to see all the things I’m covered with my plan,I also have Medicare B,my Humana plan is $44.00 a month&my Medicare part B is $144.00 a month,I need help setting it up online.

    Reply
  12. i have humana ppo do i have to register every year or am i ok .. does this renew automatically please let me know

    Reply
  13. we assumed when my sister switched to choice that it included transportation to doctor’s appts but we are on hold trying to arrange for transport.

    Reply
  14. I have Humana Choice PPO. I need to have arm lift surgery due to weight loss and aging. I’m 74, will Humana cover part of the cost. The sagging skin hurts now and it’s below my elbows along with above my elbows all the way up.

    Reply
  15. My wife receives injections with a drug called Stellar 6 times a year payed now under Medicare Supplicant with Blue Cross /Blue Shield of Texas. Would Humana cover this very.

    Reply

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