Medicare Advantage Plan With Part D Prescription Drug Coverage
Network Type
PPO
Humana Full Access H5525-042 (PPO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Ohio 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
Monthly Premium
$38
Annual Deductible
$0
Max Out-of-Pocket
$9,350
Primary doctor visit
$30 copay per visit
Specialist visit
$55 copay per visit
ER visit
$110 copay per visit (always covered)
Ambulance
$315 copay
Humana Full Access H5525-042 (PPO) has a monthly premium cost of $38 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $9,350 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 Humana Full Access H5525-042 (PPO) are defined below.
Additional Benefits and Coverage
Yes
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing
Humana Full Access H5525-042 (PPO) 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. Humana Full Access H5525-042 (PPO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Humana Full Access H5525-042 (PPO) includes coverage for the following additional benefits:
Other benefits
Fitness benefit
Limited coverage
Over the counter drug benefits
Not covered
In-home support services
Not covered
Home and bathroom safety devices
Not covered
Meals for short duration
Not covered
Annual physical exams
Limited coverage
Telehealth
Limited coverage
Comparing the Quality Score of Humana Full Access (PPO) to Other Plans in Ohio
Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2025, Humana Full Access (PPO) received an overall government quality rating of 3.5 stars out of 5 stars.
Humana Full Access (PPO) performed worse than Ohio’s State average overall quality score of 3.9 stars.
This Plan’s 5-star Gov’t Quality Score
Ohio State Average Score
Overall Government 5 Star Quality Rating
3.5
3.9
Summary rating of health plan quality
3.5
3.9
Staying healthy: screenings, tests, & vaccines
3
3.5
Managing chronic (long term) conditions
3
3.3
Member experience with health plan
4
4.2
Member complaints & changes in the health plan's performance
3
4.2
Health plan customer service
4
4.0
Summary rating of drug plan quality
3
3.9
Drug plan customer service
4
4.0
Member complaints & changes in the drug plan's performance
3
4.1
Member experience with the drug plan
4
4.0
Drug safety & accuracy of drug pricing
3
3.4
The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.
Humana Full Access (PPO) received 3.5 stars for its health plan quality score which is worse than the Ohio State average health plan quality score of 3.9 stars.
Humana Full Access (PPO) received 3 stars for its drug plan quality score which is worse than the Ohio State average drug plan quality score of 3.9 stars.
In-network: $0-720 copay or 20% coinsurance
Out-of-network: $0-720 copay or 20% coinsurance
Outpatient x-rays
In-network: $30-130 copay
Out-of-network: $30-130 copay or 50% coinsurance
Emergency care
$110 copay per visit (always covered)
Urgent care
$45 copay per visit (always covered)
Hospital Services
Inpatient hospital coverage
In-network: $470 per day for days 1 through 5
$0 per day for days 6 through 90
$0 per day for days 91 and beyond
Out-of-network: $470 per day for days 1 through 5
$0 per day for days 6 through 90
Outpatient hospital coverage
In-network: $0-470 copay per visit
Out-of-network: $0-470 copay per visit
Skilled nursing facility
Skilled nursing facility
In-network: $0 per day for days 1 through 20
$214 per day for days 21 through 100
Out-of-network: $0 per day for days 1 through 20
$214 per day for days 21 through 100
In this article we rank Ohio 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.
The Medicare landscape in Ohio 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 Ohio.
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