HumanaChoice SNP-DE H5525-048 (PPO D-SNP)

Medicare Plan Details (2023 Plan)


Monthly Premium

 

by Humana
Additional Coverage
HearingVisionDental
Overall Government Star Rating
 4.0
out of 5 stars

Ready to Enroll Online?


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

 

$0
$0
$0
$0
$12,450 In and Out-of-network
$8,300 In-network
No
Yes
Yes
Yes

Doctor Services

In-network: $0 copay
Out-of-network: 20% coinsurance per visit
In-network: $0 copay
Out-of-network: 20% coinsurance per visit

Tests, labs, & imaging

In-network: $0 copay
Out-of-network: 20% coinsurance
In-network: $0 copay
Out-of-network: $0 copay or 20% coinsurance
In-network: $0 copay
Out-of-network: 20% coinsurance
In-network: $0 copay
Out-of-network: 20% coinsurance
$0 copay
$0 copay

Hospital Services

In-network: $0 copay
Out-of-network: $2,040 per stay
In-network: $0 copay
Out-of-network: 20% coinsurance per visit

Skilled nursing facility

In-network: $0 copay
Out-of-network: $0 per day for days 1 through 20
$178 per day for days 21 through 100

Preventive services

In-network: $0 copay
Out-of-network: $0 copay or 30% coinsurance

Ambulance

In-network: $0 copay
Out-of-network: 20% coinsurance

Therapy services

In-network: $0 copay
Out-of-network: 20% coinsurance
In-network: $0 copay
Out-of-network: 20% coinsurance

Mental health services

In-network: $0 copay
Out-of-network: 20% coinsurance
In-network: $0 copay
Out-of-network: 20% coinsurance
In-network: $0 copay
Out-of-network: 20% coinsurance
In-network: $0 copay
Out-of-network: 20% coinsurance

Opioid treatment services

Covered

Other services

In-network: $0 copay
Out-of-network: 19% coinsurance per item
In-network: $0 copay
Out-of-network: 20% coinsurance per item
In-network: $0 copay
Out-of-network: $0 copay or 20% coinsurance per item

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

TiersInitial coverage phaseGap coverage phaseCatastrophic coverage phase
Preferred Generic


Generic drugs :
25%

Brand-name drugs :
25%


Generic drugs :
$4.15 copay or 5% (whichever costs more)

Brand-name drugs :
$10.35 copay or 5% (whichever costs more)

Generic
Preferred Brand
Non-Preferred Drug
Specialty Tier

Part B Drugs

In-network: $0 copay
Out-of-network: $0 copay or 20% coinsurance
In-network: $0 copay
Out-of-network: $0 copay or 20% coinsurance

Hearing

In-network: $0 copay
Out-of-network: 20% coinsurance
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay

Preventive Dental

In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay

Comprehensive dental

In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay

Vision

In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
Not covered
Not covered
Not covered

Other benefits

Limited coverage
Not covered
Not covered
Not covered
Limited coverage
Limited coverage
Limited coverage
 4
 3
 4
 4
 4
 5
 3.5
 5
 3
 4
 3

When Can I Sign Up for Medicare?

Enter your birthday month and year to learn when you can sign up for different Medicare plan options.

 

 


Ready to Enroll Online?

Advertisement

Medicare Health Plans

Get Advice & Sign Up Help
TTY 711

Speak with a Licensed Insurance Agent

Medicare65quote

No obligation to enroll. Find your plan online or speak with a licensed insurance agent to get help signing up for the right plan for you! Plan availability depends on your location. Licensed agents may not be able to provide assistance for all plans shown on this site.

Related Articles
Best Indiana Medicare Advantage Health Insurance Companies for 2023

In this article we rank Indiana Medicare Advantage plans based on our evaluation of government 5-star quality scores. Each year the government rates the quality of Medicare Advantage health insurance plans with a 5-star quality score. An overall quality score is assigned to each plan which is based on the scores of various quality metrics.

Read more →

New Indiana Medicare Advantage Health Insurance Companies for 2023

The Medicare landscape in Indiana is constantly changing. In this article we show a summary of new and returning health insurance companies offering Medicare Advantage Plans (Part C) and Medicare Prescription Drug Plans (Part D) in Indiana.

Read more →