HumanaChoice H5216-343 (PPO)
Medicare Plan Details (2023 Plan)
Monthly Premium

by Humana
Additional Coverage
Overall Government Star Rating
4.5Ready to Enroll Online?
Plan Type
Medicare Advantage (Part C)
Medicare Advantage combines Part A and Part B. This plan = Part A + Part B
Plan Details
$5,900 In-network
Medical Benefits
Doctor Services
Out-of-network: $0 copay
Out-of-network: $35 copay per visit
Tests, labs, & imaging
Out-of-network: $0-85 copay
Out-of-network: $0-85 copay
Out-of-network: $35-345 copay
Out-of-network: $0-85 copay
Hospital Services
$0 per day for days 6 through 90
$0 per day for days 91 and beyond
Out-of-network: $345 per day for days 1 through 5
$0 per day for days 6 through 90
Out-of-network: $35-345 copay per visit
Skilled nursing facility
$196 per day for days 21 through 51
$0 per day for days 52 through 100
Out-of-network: $0 per day for days 1 through 20
$196 per day for days 21 through 66
$0 per day for days 67 through 100
Preventive services
Out-of-network: $0 copay
Ambulance
Out-of-network: $300 copay
Therapy services
Out-of-network: $10-35 copay
Out-of-network: $10-35 copay
Mental health services
Out-of-network: $35 copay
Out-of-network: $35 copay
Out-of-network: $35 copay
Out-of-network: $35 copay
Opioid treatment services
Other services
Out-of-network: 20% coinsurance per item
Out-of-network: 15% coinsurance per item
Out-of-network: $10 copay or 10-20% coinsurance per item
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
Part B Drugs
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Extra Benefits
Hearing
Out-of-network: $35 copay
Out-of-network: $0 copay
Out-of-network: $0-299 copay
Preventive Dental
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Comprehensive dental
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Vision
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Other benefits
Health Plan Star Ratings
(government star ratings are out of 5 stars)
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