HumanaChoice R0110-001 (Regional PPO)


Medicare Plan Details

2021 Plan
Monthly Premium
(select county for price)

 

by Humana
Additional Coverage
Hearing Vision Dental
Overall Government Star Rating
 3.0
out of 5 stars

State: Louisiana

Select your county to view the price for this plan

 


Plan Type

Medicare Advantage (Part C)

Medicare Advantage combines Part A and Part B. This plan = Part A + Part B

 

$0
$0
$0
$1,000 annual deductible
$11,300 In and Out-of-network
$7,550 In-network
No
Yes
Yes
Yes

Medical Benefits

Doctor Services

In-network: $0 copay
Out-of-network: $35 copay per visit
In-network: $35 copay per visit
Out-of-network: $50 copay per visit

Tests, labs, & imaging

In-network: $0-50 copay
Out-of-network: $0-50 copay or 30% coinsurance
In-network: $0-40 copay
Out-of-network: $35-50 copay or 30% coinsurance
In-network: $35-150 copay
Out-of-network: $50 copay or 30% coinsurance
In-network: $0-50 copay
Out-of-network: $35-50 copay or 30% coinsurance
$90 copay per visit (always covered)
$0-50 copay or 30% coinsurance per visit (always covered)

Hospital Services

In-network: $195 per day for days 1 through 6
$0 per day for days 7 through 90
$0 per day for days 91 and beyond
Out-of-network: 30% per stay
In-network: $35-195 copay per visit
Out-of-network: $50 copay or 30% coinsurance per visit

Skilled nursing facility

In-network: $0 per day for days 1 through 20
$178 per day for days 21 through 100
Out-of-network: 30% per stay

Preventive services

In-network: $0 copay
Out-of-network: $0-50 copay or 30% coinsurance

Ambulance

In-network: $265 copay
Out-of-network: $265 copay

Therapy services

In-network: $25 copay
Out-of-network: 30% coinsurance
In-network: $25 copay
Out-of-network: 30% coinsurance

Mental health services

In-network: $35 copay
Out-of-network: $50 copay
In-network: $35 copay
Out-of-network: $50 copay
In-network: $35 copay
Out-of-network: $50 copay
In-network: $35 copay
Out-of-network: $50 copay

Opioid treatment services

Covered

Other services

In-network: 7% coinsurance per item
Out-of-network: 17% coinsurance per item
In-network: 20% coinsurance per item
Out-of-network: 30% coinsurance per item
In-network: $0 copay or 10-20% coinsurance per item
Out-of-network: 20-30% coinsurance per item

Prescription Drug Benefits

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

Part B Drugs

In-network: 20% coinsurance
Out-of-network: 30% coinsurance
In-network: 20% coinsurance
Out-of-network: 30% coinsurance

Extra Benefits

Hearing

In-network: $35 copay
Out-of-network: $50 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $699-999 copay
Out-of-network: $699-999 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
Not covered
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
Limited coverage
Not covered
Not covered
Limited coverage
Limited coverage
Limited coverage
 3
 3
 3
 3
 4
 5

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