HumanaChoice R5826-074 (Regional PPO)
Medicare Plan Details
2021 Plan
Monthly Premium
(select county for price) |

by Humana
Additional Coverage
Hearing
Overall Government Star Rating
3.5out of 5 stars
State: Florida
Select your county to view the price for this plan
Plan Type
Medicare Advantage (Part C) with Prescription Drug (Part D)
Medicare Advantage combines Part A and Part B. This plan = Part A + Part B + Part D
Plan Details
$0
$0
$0
$1,300 annual deductible
$10,500 In and Out-of-network
$7,550 In-network
$7,550 In-network
No
Yes
No
No
Medical Benefits
Doctor Services
In-network: $35 copay per visit
Out-of-network: 50% coinsurance per visit
Out-of-network: 50% coinsurance per visit
In-network: $50 copay per visit
Out-of-network: 50% coinsurance per visit
Out-of-network: 50% coinsurance per visit
Tests, labs, & imaging
In-network: $0-290 copay
Out-of-network: $0 copay or 50% coinsurance
Out-of-network: $0 copay or 50% coinsurance
In-network: $0-50 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
In-network: $50-350 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
In-network: $25-110 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
$90 copay per visit (always covered)
$25-50 copay or 50% coinsurance per visit (always covered)
Hospital Services
In-network: $625 per day for days 1 through 3
$0 per day for days 4 through 90
$0 per day for days 91 and beyond
Out-of-network: $725 per day for days 1 through 14
$0 per day for days 15 through 90
$0 per day for days 4 through 90
$0 per day for days 91 and beyond
Out-of-network: $725 per day for days 1 through 14
$0 per day for days 15 through 90
In-network: $50-390 copay per visit
Out-of-network: 50% coinsurance per visit
Out-of-network: 50% coinsurance per visit
Skilled nursing facility
In-network: $0 per day for days 1 through 20
$167 per day for days 21 through 100
Out-of-network: $250 per day for days 1 through 58
$0 per day for days 59 through 100
$167 per day for days 21 through 100
Out-of-network: $250 per day for days 1 through 58
$0 per day for days 59 through 100
Preventive services
In-network: $0 copay
Out-of-network: $0 copay or 50% coinsurance
Out-of-network: $0 copay or 50% coinsurance
Ambulance
In-network: $240 copay
Out-of-network: $240 copay
Out-of-network: $240 copay
Therapy services
In-network: $10-40 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
In-network: $10-40 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Mental health services
In-network: $40 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
In-network: $40 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
In-network: $40 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
In-network: $40 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Opioid treatment services
Covered
Other services
In-network: 20% coinsurance per item
Out-of-network: 30% coinsurance per item
Out-of-network: 30% coinsurance per item
In-network: 20% coinsurance per item
Out-of-network: 25% coinsurance per item
Out-of-network: 25% coinsurance per item
In-network: $0 copay or 20% coinsurance per item
Out-of-network: 50% coinsurance per item
Out-of-network: 50% coinsurance per item
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
Tiers | Initial coverage phase | Gap coverage phase | Catastrophic coverage phase |
---|---|---|---|
Preferred Generic | $10.00 copay |
Brand-name drugs :
|
Brand-name drugs :
|
Generic | $20.00 copay | ||
Preferred Brand | $47.00 copay | ||
Non-Preferred Drug | $100.00 copay | ||
Specialty Tier | 25% |
Part B Drugs
In-network: 20% coinsurance
Out-of-network: 20-50% coinsurance
Out-of-network: 20-50% coinsurance
In-network: 20% coinsurance
Out-of-network: 20-50% coinsurance
Out-of-network: 20-50% coinsurance
Extra Benefits
Hearing
In-network: $50 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Not covered
Not covered
Not covered
Not covered
Preventive Dental
Not covered
Not covered
Not covered
Not covered
Comprehensive dental
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Vision
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Other benefits
Not covered
Not covered
Not covered
Not covered
Not covered
Limited coverage
Limited coverage
Health Plan Star Ratings
(government star ratings are out of 5 stars)
Prescription Drug Plan Star Ratings
(government star ratings are out of 5 stars)
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