HumanaChoice SNP-DE H5525-036 (PPO D-SNP)
North Carolina Medicare-Medicaid Dual Eligible D-SNP Plan (2025 Plan)
Monthly Premium
Additional Coverage
Overall Government Star Rating
(coming soon)Ready to Enroll Online?
Plan Overview
HumanaChoice SNP-DE H5525-036 (PPO D-SNP) is a Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP), which is available in North Carolina and offered by the health insurance company Humana. This plan’s network type is PPO which determines in-network doctors who accept the health plan and whether a referral is needed.
Cost Summary
HumanaChoice SNP-DE H5525-036 (PPO D-SNP) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $14,000 In and Out-of-network $9,350 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for HumanaChoice SNP-DE H5525-036 (PPO D-SNP) are defined below.
Additional Benefits and Coverage
HumanaChoice SNP-DE H5525-036 (PPO D-SNP) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. HumanaChoice SNP-DE H5525-036 (PPO D-SNP) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. HumanaChoice SNP-DE H5525-036 (PPO D-SNP) includes coverage for the following additional benefits:
Other benefits
Plan Benefits and Coverage Details
$9,350 In-network
Medical Benefits
Doctor Services
Out-of-network: 20% coinsurance per visit
Out-of-network: 20% coinsurance per visit
Tests, labs, & imaging
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Out-of-network: $195-325 copay or 20% coinsurance
Out-of-network: $50 copay or 20% coinsurance
Hospital Services
Out-of-network: $2,185 per stay
Out-of-network: 20% coinsurance per visit
Skilled nursing facility
Out-of-network: $0 per day for days 1 through 20
$214 per day for days 21 through 100
Preventive services
Out-of-network: $0 copay
Ambulance
Out-of-network: $315 copay
Therapy services
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Mental health services
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Opioid treatment services
Other services
Out-of-network: $0 copay or 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Out-of-network: $0 copay or 20% coinsurance per item
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
| Tiers | Initial coverage phase | Catastrophic coverage phase |
|---|---|---|
| Preferred Generic |
Brand-name drugs :
|
Brand-name drugs :
|
| Generic | ||
| Preferred Brand | ||
| Non-Preferred Drug | ||
| Specialty Tier |
Part B Drugs
Out-of-network: 20% coinsurance
Out-of-network: $0 copay or 20% coinsurance
Extra Benefits
Hearing
Out-of-network: 20% coinsurance
Out-of-network: $0 copay
Out-of-network: $0 copay
Preventive Dental
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
Vision
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
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.
Speak with a Licensed Insurance Agent
Mon-Fri: 8am - 10pm ET
Sat-Sun: 8am - 9pm ET
- Medicare Advantage Plans
- Medicare Prescription Drug Plans
- Medicare Supplement Insurance Plans
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! See www.medicare65quote.com for our Third-Party Marketing Organization disclaimer.
Insurance Ad -No Government Affiliation