2022 HumanaChoice R5826-018 (Regional PPO)

HumanaChoice R5826-018 (Regional PPO) R5826-018 is a 2022 Medicare Advantage Plan or Part-C by Humana available to residents in Florida. This plan does not provide additional prescription drug (Part-D) coverage. The HumanaChoice R5826-018 (Regional PPO) has a monthly premium of $0 and has an in-network maximum out-of-pocket limit of $7,550 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $7,550 out-of-pocket. This can be a extremely nice safety net.

HumanaChoice R5826-018 (Regional PPO) is a Regional 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 HumanaChoice R5826-018 (Regional 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 HumanaChoice R5826-018 (Regional 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	Not covered
Extractions	50% coinsurance (Out-of-Network)
Extractions	0% coinsurance
Non-routine services	Not covered
Periodontics	Not covered
Prosthodontics, other oral/maxillofacial surgery, other services	50% coinsurance (Out-of-Network)
Prosthodontics, other oral/maxillofacial surgery, other services	0% coinsurance
Restorative services	50% coinsurance (Out-of-Network)
Restorative services	0% coinsurance

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Deductible

$1,300 annual deductible

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Diagnostic Tests and Procedures

Diagnostic radiology services (e.g., MRI)	$45-75 copay or 30% coinsurance (Out-of-Network)
Diagnostic radiology services (e.g., MRI)	$45-125 copay
Diagnostic tests and procedures	$0-100 copay
Diagnostic tests and procedures	$0-45 copay or 30% coinsurance (Out-of-Network)
Lab services	$0-50 copay
Lab services	$45 copay or 30% coinsurance (Out-of-Network)
Outpatient x-rays	$45 copay or 30% coinsurance (Out-of-Network)
Outpatient x-rays	$10-100 copay

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Doctor Visits

Primary	$10 copay per visit
Primary	$45 copay per visit (Out-of-Network)
Specialist	$45 copay per visit
Specialist	$45 copay per visit (Out-of-Network)

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Emergency care/Urgent Care

Emergency	$90 copay per visit (always covered)
Urgent care	$10-45 copay or 30% coinsurance per visit (always covered)

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Foot Care (podiatry services)

Foot exams and treatment	$45 copay
Foot exams and treatment	$45 copay (Out-of-Network)
Routine foot care	Not covered

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Ground Ambulance

$240 copay
$240 copay (Out-of-Network)

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Hearing

Fitting/evaluation	25% coinsurance (Out-of-Network)
Fitting/evaluation	$0 copay
Hearing aids	25% coinsurance (Out-of-Network)
Hearing aids	$0 copay
Hearing exam	$45 copay (Out-of-Network)
Hearing exam	$45 copay

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Inpatient Hospital Coverage

$311 per day for days 1 through 7 $0 per day for days 8 through 90 $0 per day for days 91 and beyond
$315 per day for days 1 through 7 $0 per day for days 8 through 90 (Out-of-Network)

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Medical Equipment/Supplies

Diabetes supplies	30% coinsurance per item (Out-of-Network)
Diabetes supplies	$0 copay or 20% coinsurance per item
Durable medical equipment (e.g., wheelchairs, oxygen)	20% coinsurance per item (Out-of-Network)
Durable medical equipment (e.g., wheelchairs, oxygen)	20% coinsurance per item
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	20-30% coinsurance (Out-of-Network)
Other Part B drugs	20-30% coinsurance (Out-of-Network)
Other Part B drugs	20% coinsurance

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Mental Health Services

Inpatient hospital - psychiatric	$245 per day for days 1 through 10 $0 per day for days 11 through 90 (Out-of-Network)
Inpatient hospital - psychiatric	$195 per day for days 1 through 9 $0 per day for days 10 through 90
Outpatient group therapy visit	$45 copay (Out-of-Network)
Outpatient group therapy visit	$40 copay
Outpatient group therapy visit with a psychiatrist	$45 copay (Out-of-Network)
Outpatient group therapy visit with a psychiatrist	$40 copay
Outpatient individual therapy visit	$40 copay
Outpatient individual therapy visit	$45 copay (Out-of-Network)
Outpatient individual therapy visit with a psychiatrist	$40 copay
Outpatient individual therapy visit with a psychiatrist	$45 copay (Out-of-Network)

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MOOP

$10,000 In and Out-of-network $7,550 In-network

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Option

No

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Optional supplemental benefits

No

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Outpatient Hospital Coverage

$45 copay or 30% coinsurance per visit (Out-of-Network)
$45-100 copay per visit

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Preventive Care

$0 copay
$0-45 copay or 30% coinsurance (Out-of-Network)

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Preventive Dental

Cleaning	50% coinsurance (Out-of-Network)
Cleaning	$0 copay
Dental x-ray(s)	$0 copay
Dental x-ray(s)	50% coinsurance (Out-of-Network)
Fluoride treatment	Not covered
Oral exam	$0 copay
Oral exam	50% coinsurance (Out-of-Network)

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Rehabilitation Services

Occupational therapy visit	$25-40 copay
Occupational therapy visit	$45 copay or 30% coinsurance (Out-of-Network)
Physical therapy and speech and language therapy visit	$45 copay or 30% coinsurance (Out-of-Network)
Physical therapy and speech and language therapy visit	$25-40 copay

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Skilled Nursing Facility

$250 per day for days 1 through 58 $0 per day for days 59 through 100 (Out-of-Network)
$0 per day for days 1 through 20 $150 per day for days 21 through 100

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Transportation

Not covered

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Vision

Contact lenses	Not covered
Eyeglass frames	Not covered
Eyeglass lenses	Not covered
Eyeglasses (frames and lenses)	Not covered
Other	Not covered
Routine eye exam	Not covered
Upgrades	Not covered

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Wellness Programs (e.g. fitness nursing hotline)

Covered

CMS Star Ratings for HumanaChoice R5826-018 (Regional PPO) R5826

Staying Healthy, Screening, Testing, & Vaccines

Managing Chronic And Long Term Care for Older Adults

Member Experience with Health Plan

Member Complaints and Changes in HumanaChoice R5826-018 (Regional PPO) Plans Performance

Health Plan Customer Service Rating for HumanaChoice R5826-018 (Regional PPO)

HumanaChoice R5826-018 (Regional 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 HumanaChoice R5826-018 (Regional 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.