HumanaChoice R1390-001 (Regional PPO)


Medicare Plan Details

2020 Plan
Monthly Premium
(select county for price)

 

by Humana
Additional Coverage
Hearing Vision
Overall Government Star Rating
 4.0
out of 5 stars

State: Virginia

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
$5,400 In and Out-of-network
$5,400 In-network
No
Yes
Yes
No

Medical Benefits

Doctor Services

In-network: $15 per visit
Out-of-network: $15-110 per visit
In-network: $50 per visit
Out-of-network: $50 per visit

Tests, labs, & imaging

In-network: $0-100
Out-of-network: $0-100
In-network: $0-50
Out-of-network: $0-100
In-network: $50-275
Out-of-network: $50-275
In-network: $15-110
Out-of-network: $15-110
$90 per visit (always covered)
$15-50 per visit (always covered)

Hospital Services

In-network: $275 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: $275 per day for days 1 through 6
$0 per day for days 7 through 90
In-network: $50-275 per visit
Out-of-network: $50-275 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: $10-40
In-network: $10-40
Out-of-network: $10-40

Mental health services

In-network: $40
Out-of-network: $40-100
In-network: $40
Out-of-network: $40-100
In-network: $40
Out-of-network: $40-100
In-network: $40
Out-of-network: $40-100

Opioid treatment services

Covered

Other services

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

Prescription Drug Benefits

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

Part B Drugs

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

Extra Benefits

Hearing

In-network: $50
Out-of-network: $50
In-network: $0 copay
Out-of-network: $0 copay
In-network: $699-999
Out-of-network: $699-999

Preventive Dental

Not covered
Not covered
Not covered
Not covered

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
 4
 3
 4
 4
 4
 4

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