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  1. VA
  2. Humana
  3. Plan

HumanaChoice R1390-001 (Regional PPO)

Medicare Plan Details (2023 Plan)

Monthly Premium

 

by Humana
Additional Coverage
HearingVision
Overall Government Star Rating
 3.5
out of 5 stars

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Plan Type

Medicare Advantage (Part C)

Medicare Advantage combines Part A and Part B. This plan = Part A + Part B

 

Plan Details

$0
$0
$0
$0
$10,000 In and Out-of-network
$6,950 In-network
No
Yes
Yes
No
https://finder.humana.com/finder/medical
http://www.humana.com/medicare

Medical Benefits

Doctor Services

In-network: $0 copay
Out-of-network: $0 copay
In-network: $50 copay per visit
Out-of-network: $50 copay per visit

Tests, labs, & imaging

In-network: $0-100 copay
Out-of-network: $0-110 copay
In-network: $0-50 copay
Out-of-network: $0-110 copay
In-network: $50-295 copay
Out-of-network: $50-395 copay
In-network: $0-110 copay
Out-of-network: $0-110 copay
$95 copay per visit (always covered)
$40 copay per visit (always covered)

Hospital Services

In-network: $395 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: $395 per day for days 1 through 5
$0 per day for days 6 through 90
In-network: $50-395 copay per visit
Out-of-network: $50-395 copay per visit

Skilled nursing facility

In-network: $0 per day for days 1 through 20
$196 per day for days 21 through 56
$0 per day for days 57 through 100
Out-of-network: $0 per day for days 1 through 20
$196 per day for days 21 through 72
$0 per day for days 73 through 100

Preventive services

In-network: $0 copay
Out-of-network: $0 copay

Ambulance

In-network: $300 copay
Out-of-network: $300 copay

Therapy services

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

Mental health services

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

Opioid treatment services

Covered

Other services

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

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

Extra Benefits

Hearing

In-network: $50 copay
Out-of-network: $50 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $399-699 copay
Out-of-network: $399-699 copay

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

Other benefits

Limited coverage
Limited coverage
Not covered
Not covered
Limited coverage
Limited coverage
Limited coverage

Health Plan Star Ratings

(government star ratings are out of 5 stars)
 3.5
 4
 4
 3
 3
 5

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