Humana USAA Honor (HMO)
H5619 - 121 - 0
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Humana USAA Honor (HMO) is a Medicare Advantage (Part C) Plan by Humana.
This page features plan details for 2024 Humana USAA Honor (HMO) H5619 – 121 – 0 available in Select Counties in California.
IMPORTANT: This page has been updated with plan and premium data for 2024.
Locations
Humana USAA Honor (HMO) is offered in the following locations.
Plan Overview
Humana USAA Honor (HMO) offers the following coverage and cost-sharing.
| Insurer: | Humana |
| Health Plan Deductible: | $0.00 |
| MOOP: | $4,999 In-network |
| Drugs Covered: | No |
Ready to sign up for Humana USAA Honor (HMO) ?
Medicare Part B Give Back Benefit
The Part B Premium Reduction (Medicare Part B Give Back Benefit) lowers the cost of some Medicare Advantage plans.
Humana USAA Honor (HMO) qualifies for a monthly Medicare Give Back Benefit of $75.00.
| Premium Reduction: | $75.00 |
Premium Breakdown
Humana USAA Honor (HMO) has a monthly premium of $0.00. This amount includes your Part C premium but does not include your Part B premium.| Part B | Part C | Part B Give Back | Total |
|---|---|---|---|
| $174.70 | $0.00 | $75.00 | $99.70 |
- Your Part B premium may differ based on factors including late enrollment, income, and disability status.
Additional Benefits
Humana USAA Honor (HMO) also provides the following benefits.
| $0 |
| In-network | No |
| $4,999 In-network |
| Yes |
| In-network | No |
| $0-295 copay per visit (Authorization is required.) (Referral is required.) |
| Primary | $0 copay (Not applicable.) (Not applicable.) |
| Specialist | $0 copay (Authorization is required.) (Referral is required.) |
| $0 copay (Authorization is not required.) (Referral is not required.) |
| Emergency | $90 copay per visit (always covered) (Not applicable.) (Not applicable.) |
| Urgent care | $30 copay per visit (always covered) (Not applicable.) (Not applicable.) |
| Diagnostic tests and procedures | $0-30 copay or 20% coinsurance (Authorization is required.) (Referral is required.) |
| Lab services | $0-15 copay (Authorization is required.) (Referral is required.) |
| Diagnostic radiology services (e.g., MRI) | $0 copay (Authorization is required.) (Referral is required.) |
| Outpatient x-rays | $0 copay (Authorization is required.) (Referral is required.) |
| Hearing exam | $0 copay (Authorization is required.) (Referral is required.) |
| Fitting/evaluation | $0 copay (There are no limits.) (Authorization is required.) (Referral is required.) |
| Hearing aids | $499-799 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Oral exam | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Cleaning | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Fluoride treatment | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Dental x-ray(s) | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Non-routine services | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Diagnostic services | $0 copay (Limits may apply.) (Authorization is required.) (Referral is required.) |
| Restorative services | $0 copay (Limits may apply.) (Authorization is required.) (Referral is required.) |
| Endodontics | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Periodontics | $0 copay (Limits may apply.) (Authorization is required.) (Referral is required.) |
| Extractions | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Prosthodontics, other oral/maxillofacial surgery, other services | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Routine eye exam | $0 copay (Limits may apply.) (Authorization is required.) (Referral is required.) |
| Other | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Contact lenses | $0 copay (Limits may apply.) (Authorization is required.) (Referral is required.) |
| Eyeglasses (frames and lenses) | $0 copay (Limits may apply.) (Authorization is required.) (Referral is required.) |
| Eyeglass frames | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Eyeglass lenses | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Upgrades | Not covered (Not applicable.) (Not applicable.) |
| Occupational therapy visit | $10 copay (Authorization is required.) (Referral is required.) |
| Physical therapy and speech and language therapy visit | $10 copay (Authorization is required.) (Referral is required.) |
| $265 copay (Not applicable.) (Not applicable.) |
| Not covered (Not applicable.) (Not applicable.) |
| Foot exams and treatment | $0 copay (Authorization is required.) (Referral is required.) |
| Routine foot care | Not covered (Not applicable.) (Not applicable.) |
| Durable medical equipment (e.g., wheelchairs, oxygen) | 20% coinsurance per item (Authorization is required.) (Not applicable.) |
| Prosthetics (e.g., braces, artificial limbs) | 20% coinsurance per item (Authorization is required.) (Not applicable.) |
| Diabetes supplies | $0 copay or 10% coinsurance per item (Authorization is required.) (Not applicable.) |
| Not covered (Not applicable.) (Not applicable.) |
| Chemotherapy | 0-20% coinsurance (Authorization is required.) (Not applicable.) |
| Other Part B drugs | 0-20% coinsurance (Authorization is required.) (Not applicable.) |
| Part B Insulin drugs | 0-20% coinsurance (up to $35) (Authorization is required.) (Not applicable.) |
| $295 per day for days 1 through 6 $0 per day for days 7 through 90 $0 per day for days 90 and beyond (Authorization is required.) (Referral is required.) |
| Inpatient hospital – psychiatric | $1,260 per stay (Authorization is required.) (Referral is required.) |
| Outpatient group therapy visit with a psychiatrist | $30 copay (Authorization is required.) (Referral is required.) |
| Outpatient individual therapy visit with a psychiatrist | $30 copay (Authorization is required.) (Referral is required.) |
| Outpatient group therapy visit | $30 copay (Authorization is required.) (Referral is required.) |
| Outpatient individual therapy visit | $30 copay (Authorization is required.) (Referral is required.) |
| $0 per day for days 1 through 20 $178 per day for days 21 through 100 (Authorization is required.) (Referral is required.) |
| Monthly Premium | $51.20 |
| Deductible | nan |
Ready to sign up for Humana USAA Honor (HMO) ?
Table of Contents
SMID: MULTIPLAN_HCIHNDOGMED01_M
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