Humana USAA Honor (PPO)

H5216 - 201 - 0
4.5 out of 5 stars (4.5 / 5)

humana medicare provider logo

Humana USAA Honor (PPO) is a Medicare Advantage Plan by Humana.

This page features plan details for 2024 Humana USAA Honor (PPO) H5216 – 201 – 0 available in Louisiana.

IMPORTANT: This page features the 2024 version of this plan. See the 2025 version using the link below:

Locations

Humana USAA Honor (PPO) is offered in the following locations.

Plan Overview

Humana USAA Honor (PPO) offers the following coverage and cost-sharing.

Insurer:Humana
Health Plan Deductible:$0.00
MOOP:$8,950 In and Out-of-network
$4,900 In-network
Drugs Covered:No

Ready to sign up for Humana USAA Honor (PPO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

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 (PPO) qualifies for a monthly Medicare Give Back Benefit of $88.00.

Premium Reduction:$88.00

Premium Breakdown

Humana USAA Honor (PPO) 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 $88.00 $
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.

Additional Benefits

Humana USAA Honor (PPO) also provides the following benefits.

Health plan deductible

$0

Other health plan deductibles?

In-network No

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

$8,950 In and Out-of-network
$4,900 In-network

Optional supplemental benefits

No

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

In-network Yes, contact plan for further details

Outpatient hospital coverage

In-network $0-195 copay per visit (Authorization is required.) (Referral is not required.)
out-of-network $50 copay or 30% coinsurance per visit (Authorization is required.) (Referral is not required.)

Doctor visits

In-network Primary$0 copay (Not applicable.) (Not applicable.)
out-of-network Primary$35 copay per visit (Not applicable.) (Not applicable.)
In-network Specialist$35 copay per visit (Authorization is not required.) (Referral is not required.)
out-of-network Specialist$50 copay per visit (Authorization is not required.) (Referral is not required.)

Preventive care

In-network $0 copay (Authorization is not required.) (Referral is not required.)
out-of-network $0 copay or 30% coinsurance (Authorization is not required.) (Referral is not required.)

Emergency care/Urgent care

Emergency$120 copay per visit (always covered) (Not applicable.) (Not applicable.)
Urgent care$60 copay per visit (always covered) (Not applicable.) (Not applicable.)

Diagnostic procedures/lab services/imaging

In-network Diagnostic tests and procedures$0-60 copay (Authorization is required.) (Referral is not required.)
out-of-network Diagnostic tests and procedures$35-50 copay or 30% coinsurance (Authorization is required.) (Referral is not required.)
In-network Lab services$0-40 copay (Authorization is required.) (Referral is not required.)
out-of-network Lab services$35-50 copay or 30% coinsurance (Authorization is required.) (Referral is not required.)
In-network Diagnostic radiology services (e.g., MRI)$0-150 copay (Authorization is required.) (Referral is not required.)
out-of-network Diagnostic radiology services (e.g., MRI)$50 copay or 30% coinsurance (Authorization is required.) (Referral is not required.)
In-network Outpatient x-rays$0-60 copay (Authorization is required.) (Referral is not required.)
out-of-network Outpatient x-rays$35-50 copay or 30% coinsurance (Authorization is required.) (Referral is not required.)

Hearing

In-network Hearing exam$35 copay (Authorization is required.) (Referral is not required.)
out-of-network Hearing exam$50 copay (Authorization is required.) (Referral is not required.)
In-network Fitting/evaluation$0 copay (There are no limits.) (Authorization is required.) (Referral is not required.)
out-of-network Fitting/evaluation$0-50 copay or 30% coinsurance (There are no limits.) (Authorization is required.) (Referral is not required.)
In-network Hearing aids$699-999 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
out-of-network Hearing aids$699-999 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)

Preventive dental

In-network Oral exam$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
out-of-network Oral exam$0-50 copay or 30% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.)
In-network Cleaning$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
out-of-network Cleaning$0-50 copay or 30% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.)
In-network Fluoride treatment$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
out-of-network Fluoride treatment$0-50 copay or 30% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.)
In-network Dental x-ray(s)$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
out-of-network Dental x-ray(s)$0-50 copay or 30% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.)

Comprehensive dental

In-network Non-routine services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Non-routine services$0-50 copay or 30% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Diagnostic services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Diagnostic services$0-50 copay or 30% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Restorative services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Restorative services$0-50 copay or 30% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Endodontics$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Endodontics$0-50 copay or 30% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Periodontics$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Periodontics$0-50 copay or 30% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Extractions$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Extractions$0-50 copay or 30% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Prosthodontics, other oral/maxillofacial surgery, other services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Prosthodontics, other oral/maxillofacial surgery, other services$0-50 copay or 30% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)

Vision

In-network Routine eye exam$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Routine eye exam$0-50 copay or 30% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
OtherNot covered (There are no limits.) (Not applicable.) (Not applicable.)
In-network Contact lenses$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Contact lenses$0-50 copay or 30% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Eyeglasses (frames and lenses)$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Eyeglasses (frames and lenses)$0-50 copay or 30% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
Eyeglass framesNot covered (There are no limits.) (Not applicable.) (Not applicable.)
Eyeglass lensesNot covered (There are no limits.) (Not applicable.) (Not applicable.)
UpgradesNot covered (Not applicable.) (Not applicable.)

Rehabilitation services

In-network Occupational therapy visit$20 copay (Authorization is required.) (Referral is not required.)
out-of-network Occupational therapy visit30% coinsurance (Authorization is required.) (Referral is not required.)
In-network Physical therapy and speech and language therapy visit$20 copay (Authorization is required.) (Referral is not required.)
out-of-network Physical therapy and speech and language therapy visit30% coinsurance (Authorization is required.) (Referral is not required.)

Ground ambulance

In-network $300 copay (Not applicable.) (Not applicable.)
out-of-network $300 copay (Not applicable.) (Not applicable.)

Transportation

In-network $0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)

Foot care (podiatry services)

In-network Foot exams and treatment$35 copay (Authorization is required.) (Referral is not required.)
out-of-network Foot exams and treatment$50 copay (Authorization is required.) (Referral is not required.)
Routine foot careNot covered (Not applicable.) (Not applicable.)

Medical equipment/supplies

In-network Durable medical equipment (e.g., wheelchairs, oxygen)7% coinsurance per item (Authorization is required.) (Not applicable.)
out-of-network Durable medical equipment (e.g., wheelchairs, oxygen)17% coinsurance per item (Authorization is required.) (Not applicable.)
In-network Prosthetics (e.g., braces, artificial limbs)20% coinsurance per item (Authorization is required.) (Not applicable.)
out-of-network Prosthetics (e.g., braces, artificial limbs)30% coinsurance per item (Authorization is required.) (Not applicable.)
In-network Diabetes supplies$0 copay or 10-20% coinsurance per item (Authorization is required.) (Not applicable.)
out-of-network Diabetes supplies20-30% coinsurance per item (Authorization is required.) (Not applicable.)

Wellness programs (e.g., fitness, nursing hotline)

Covered (Authorization is required.) (Referral is not required.)

Medicare Part B drugs

In-network Chemotherapy0-20% coinsurance (Authorization is required.) (Not applicable.)
out-of-network Chemotherapy30% coinsurance (Authorization is required.) (Not applicable.)
In-network Other Part B drugs0-20% coinsurance (Authorization is required.) (Not applicable.)
out-of-network Other Part B drugs30% coinsurance (Authorization is required.) (Not applicable.)
In-network Part B Insulin drugs0-20% coinsurance (up to $35) (Authorization is required.) (Not applicable.)
out-of-network Part B Insulin drugs30% coinsurance (Authorization is required.) (Not applicable.)

Inpatient hospital coverage

In-network $225 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 not required.)
out-of-network 30% per stay (Authorization is required.) (Referral is not required.)

Mental health services

In-network Inpatient hospital – psychiatric$225 per day for days 1 through 6
$0 per day for days 7 through 90 (Authorization is required.) (Referral is not required.)
out-of-network Inpatient hospital – psychiatric30% per stay (Authorization is required.) (Referral is not required.)
In-network Outpatient group therapy visit with a psychiatrist$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Outpatient group therapy visit with a psychiatrist$50 copay (Authorization is required.) (Referral is not required.)
In-network Outpatient individual therapy visit with a psychiatrist$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Outpatient individual therapy visit with a psychiatrist$50 copay (Authorization is required.) (Referral is not required.)
In-network Outpatient group therapy visit$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Outpatient group therapy visit$50 copay (Authorization is required.) (Referral is not required.)
In-network Outpatient individual therapy visit$0 copay (Authorization is required.) (Referral is not required.)
out-of-network Outpatient individual therapy visit$50 copay (Authorization is required.) (Referral is not required.)

Skilled Nursing Facility

In-network $0 per day for days 1 through 20
$203 per day for days 21 through 100 (Authorization is required.) (Referral is not required.)
out-of-network 30% per stay (Authorization is required.) (Referral is not required.)

Ready to sign up for Humana USAA Honor (PPO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

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