2022 Humana Honor (PPO)

Humana Honor (PPO) H5216-221 is a 2022 Medicare Advantage Plan or Part-C by Humana available to residents in Pennsylvania and New Jersey. This plan does not provide additional prescription drug (Part-D) coverage. The Humana Honor (PPO) has a monthly premium of $0 and has an in-network maximum out-of-pocket limit of $6,700 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $6,700 out-of-pocket. This can be a extremely nice safety net.

Humana Honor (PPO) is a Local PPO *. A preferred provider organization (PPO) is a Medicare plan that has created contracts with a network of "preferred" providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network. Offering you a little more flexibility overall. You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate.

Humana works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Humana Honor (PPO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Humana and not Original Medicare. With Medicare Advantage you are always covered for urgently needed and emergency care. Plus you receive all the benefits of Original Medicare from Humana except hospice care. Original Medicare still provides you with hospice care even if you sign up for Medicare Advantage.

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2022 Humana Medicare Advantage Plan Costs

2021 Humana Honor (PPO) Summary of Benefits

*This will be updated with 2022 data when available.

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Additional Benefits

No

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Comprehensive Dental

Diagnostic services	Not covered
Endodontics	$0 copay (Out-of-Network)
Endodontics	$0 copay
Extractions	$0 copay (Out-of-Network)
Extractions	$0 copay
Non-routine services	$0 copay
Non-routine services	$0 copay (Out-of-Network)
Periodontics	$0 copay (Out-of-Network)
Periodontics	$0 copay
Prosthodontics, other oral/maxillofacial surgery, other services	$0 copay
Prosthodontics, other oral/maxillofacial surgery, other services	$0 copay (Out-of-Network)
Restorative services	$0 copay
Restorative services	$0 copay (Out-of-Network)

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Deductible

$0

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Diagnostic Tests and Procedures

Diagnostic radiology services (e.g., MRI)	$20-295 copay (Out-of-Network)
Diagnostic radiology services (e.g., MRI)	$20-295 copay
Diagnostic tests and procedures	$0-50 copay
Diagnostic tests and procedures	$0-50 copay (Out-of-Network)
Lab services	$0-50 copay (Out-of-Network)
Lab services	$0-50 copay
Outpatient x-rays	$20-110 copay (Out-of-Network)
Outpatient x-rays	$20-110 copay

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Doctor Visits

Primary	$20 copay per visit
Primary	$20-110 copay per visit (Out-of-Network)
Specialist	$50 copay per visit (Out-of-Network)
Specialist	$50 copay per visit

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Emergency care/Urgent Care

Emergency	$90 copay per visit (always covered)
Urgent care	$20-50 copay per visit (always covered)

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Foot Care (podiatry services)

Foot exams and treatment	$50 copay
Foot exams and treatment	$50 copay (Out-of-Network)
Routine foot care	Not covered

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Ground Ambulance

$290 copay
$290 copay (Out-of-Network)

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Hearing

Fitting/evaluation	$0 copay (Out-of-Network)
Fitting/evaluation	$0 copay
Hearing aids	$699-999 copay (Out-of-Network)
Hearing aids	$699-999 copay
Hearing exam	$50 copay
Hearing exam	$50 copay (Out-of-Network)

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Inpatient Hospital Coverage

$295 per day for days 1 through 7 $0 per day for days 8 through 90 (Out-of-Network)
$295 per day for days 1 through 7 $0 per day for days 8 through 90 $0 per day for days 91 and beyond

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Medical Equipment/Supplies

Diabetes supplies	$10 copay or 10-20% coinsurance per item (Out-of-Network)
Diabetes supplies	$0 copay or 10-20% coinsurance per item
Durable medical equipment (e.g., wheelchairs, oxygen)	18% coinsurance per item
Durable medical equipment (e.g., wheelchairs, oxygen)	$50 copay or 18-20% coinsurance per item (Out-of-Network)
Prosthetics (e.g., braces, artificial limbs)	20% coinsurance per item (Out-of-Network)
Prosthetics (e.g., braces, artificial limbs)	20% coinsurance per item

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Medicare Part B Drugs

Chemotherapy	20% coinsurance
Chemotherapy	20% coinsurance (Out-of-Network)
Other Part B drugs	20% coinsurance (Out-of-Network)
Other Part B drugs	20% coinsurance

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Mental Health Services

Inpatient hospital - psychiatric	$295 per day for days 1 through 6 $0 per day for days 7 through 90
Inpatient hospital - psychiatric	$295 per day for days 1 through 6 $0 per day for days 7 through 90 (Out-of-Network)
Outpatient group therapy visit	$40-100 copay (Out-of-Network)
Outpatient group therapy visit	$40 copay
Outpatient group therapy visit with a psychiatrist	$40 copay
Outpatient group therapy visit with a psychiatrist	$40-100 copay (Out-of-Network)
Outpatient individual therapy visit	$40-100 copay (Out-of-Network)
Outpatient individual therapy visit	$40 copay
Outpatient individual therapy visit with a psychiatrist	$40 copay
Outpatient individual therapy visit with a psychiatrist	$40-100 copay (Out-of-Network)

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MOOP

$10,000 In and Out-of-network $6,700 In-network

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Option

No

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Optional supplemental benefits

No

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Outpatient Hospital Coverage

$20-295 copay per visit (Out-of-Network)
$50-295 copay per visit

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Preventive Care

$0 copay (Out-of-Network)
$0 copay

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Preventive Dental

Cleaning	$0 copay (Out-of-Network)
Cleaning	$0 copay
Dental x-ray(s)	$0 copay
Dental x-ray(s)	$0 copay (Out-of-Network)
Fluoride treatment	$0 copay
Fluoride treatment	$0 copay (Out-of-Network)
Oral exam	$0 copay
Oral exam	$0 copay (Out-of-Network)

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Rehabilitation Services

Occupational therapy visit	$10-40 copay
Occupational therapy visit	$10-40 copay (Out-of-Network)
Physical therapy and speech and language therapy visit	$10-40 copay
Physical therapy and speech and language therapy visit	$10-40 copay (Out-of-Network)

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Skilled Nursing Facility

$0 per day for days 1 through 20 $184 per day for days 21 through 100
$0 per day for days 1 through 20 $184 per day for days 21 through 100 (Out-of-Network)

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Transportation

50% coinsurance (Out-of-Network)
$0 copay

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Vision

Contact lenses	$0 copay (Out-of-Network)
Contact lenses	$0 copay
Eyeglass frames	Not covered
Eyeglass lenses	Not covered
Eyeglasses (frames and lenses)	$0 copay (Out-of-Network)
Eyeglasses (frames and lenses)	$0 copay
Other	Not covered
Routine eye exam	$0 copay (Out-of-Network)
Routine eye exam	$0 copay
Upgrades	Not covered

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Wellness Programs (e.g. fitness nursing hotline)

Covered

CMS Star Ratings for Humana Honor (PPO) H5216

Staying Healthy, Screening, Testing, & Vaccines

Managing Chronic And Long Term Care for Older Adults

Member Experience with Health Plan

Member Complaints and Changes in Humana Honor (PPO) Plans Performance

Health Plan Customer Service Rating for Humana Honor (PPO)

Humana Honor (PPO) Drug Plan Customer Service Ratings

Ratings For Member Complaints and Changes in the Drug Plans Performance

Member Experience with the Drug Plan

Drug Safety and Accuracy of Drug Pricing

Ready to Enroll?

Click Here

Or Call
1-855-778-4180
Mon-Fri 8am-8pm EST
Sat 8am-8pm EST

Coverage Area for Humana Honor (PPO)

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Source: CMS.
Data as of September 1, 2021.
Notes: Data are subject to change as contracts are finalized. For 2022, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit. Includes 2022 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.