HumanaChoice R3887-001 (Regional PPO)


Medicare Plan Details

2020 Plan
Monthly Premium
(select county for price)

 

by Humana
Additional Coverage
Hearing Vision Dental
Overall Government Star Rating
 3.5
out of 5 stars

State: Michigan

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
$0
$5,500 In and Out-of-network
$5,500 In-network
No
Yes
Yes
Yes

Medical Benefits

Doctor Services

In-network: $10 per visit
Out-of-network: $10-45 per visit
In-network: $45 per visit
Out-of-network: $45 per visit

Tests, labs, & imaging

In-network: $0-95
Out-of-network: $0-95
In-network: $0-35
Out-of-network: $0-95
In-network: $40-350
Out-of-network: $40-350
In-network: $10-110
Out-of-network: $10-110
$90 per visit (always covered)
$10-45 per visit (always covered)

Hospital Services

In-network: $295 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: $295 per day for days 1 through 6
$0 per day for days 7 through 90
In-network: $45-270 per visit
Out-of-network: $45-270 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: $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

Ambulance

In-network: $270
Out-of-network: $270

Therapy services

In-network: $10-40
Out-of-network: $10-45
In-network: $10-40
Out-of-network: $10-45

Mental health services

In-network: $40
Out-of-network: $40-350
In-network: $40
Out-of-network: $40-350
In-network: $40
Out-of-network: $40-350
In-network: $40
Out-of-network: $40-350

Opioid treatment services

Covered

Other services

In-network: $0 copay
Out-of-network: $0 copay
In-network: 20% per item
Out-of-network: 19-20% per item
In-network: $0 or 10-20% per item
Out-of-network: $0 or 20% per item

Prescription Drug Benefits

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

Part B Drugs

In-network: 19%
Out-of-network: 19-20%
In-network: 19%
Out-of-network: 19-20%

Extra Benefits

Hearing

In-network: $45
Out-of-network: $45
In-network: $0 copay
Out-of-network: $0 copay
In-network: $699-999
Out-of-network: $699-999

Preventive Dental

In-network: $0 copay
Out-of-network: 50%
In-network: $0 copay
Out-of-network: 50%
Not covered
In-network: $0 copay
Out-of-network: 50%

Comprehensive dental

Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered

Vision

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

Other benefits

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

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