HumanaChoice R5826-074 (Regional PPO) is a Medicare Advantage (Part C) Plan by Humana.
This page features plan details for 2024 HumanaChoice R5826-074 (Regional PPO) R5826 – 074 – 0 available in Florida RPPO.
IMPORTANT: This page has been updated with plan and premium data for 2024.
HumanaChoice R5826-074 (Regional PPO) is offered in the following locations.
HumanaChoice R5826-074 (Regional PPO) offers the following coverage and cost-sharing.
Insurer: | Humana |
Health Plan Deductible: | $1,300 annual deductible |
MOOP: | $7,550.00 |
Drugs Covered: | Yes |
Ready to sign up for HumanaChoice R5826-074 (Regional PPO) ?
Part B | Part C | Part D | Part B Give Back | Total |
---|---|---|---|---|
$174.70 | $0.00 | $31.00 | $0.00 | $205.70 |
HumanaChoice R5826-074 (Regional PPO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.
Drug Deductible: | $395.00 |
Initial Coverage Limit: | $5,030.00 |
Catastrophic Coverage Limit: | $8,000.00 |
Drug Benefit Type: | Enhanced Alternative |
Additional Gap Coverage: | |
Formulary Link: | Formulary Link |
The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs.
The table below shows how the LIS impacts the Part D premium of this plan.
Part D | LIS Full |
---|---|
$31.00 | $ |
NOTE: The Inflation Reduction Act of 2022 has expanded full subsidy eligibility under the LIS program to individuals with incomes up to 150% of the Federal Poverty Level. People who qualify for Extra Help generally will pay no more than $4.50 for each generic drug and $11.20 for each brand-name drug.
After you pay your $395.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $5,030.00. Once you reach that amount, you will enter the next coverage phase.
Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
---|---|---|---|---|
1 (Preferred Generic) | $6.00 copay | $6.00 copay | $10.00 copay | |
2 (Generic) | $20.00 copay | $20.00 copay | $20.00 copay | |
3 (Preferred Brand) | $47.00 copay | $47.00 copay | $47.00 copay | |
4 (Non-Preferred Drug) | $100.00 copay | $100.00 copay | $100.00 copay | |
5 (Specialty Tier) | 27% | 27% | 27% |
Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
---|---|---|---|---|
1 (Preferred Generic) | ||||
2 (Generic) | ||||
3 (Preferred Brand) | ||||
4 (Non-Preferred Drug) | ||||
5 (Specialty Tier) |
Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
---|---|---|---|---|
1 (Preferred Generic) | $18.00 copay | $0.00 copay | $30.00 copay | |
2 (Generic) | $60.00 copay | $0.00 copay | $60.00 copay | |
3 (Preferred Brand) | $141.00 copay | $131.00 copay | $141.00 copay | |
4 (Non-Preferred Drug) | $300.00 copay | $290.00 copay | $300.00 copay | |
5 (Specialty Tier) |
After your total drug costs (including what this plan has paid and what you have paid) reach $5,030.00, you will pay no more than the amounts below for any drug tier until you reach $8,000.00.
Tier | Cost |
---|---|
All other tiers (Generic) | 25% |
All other tiers (Brand-name) | 25% |
After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $8,000.00, you pay nothing for Medicare Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit. Please note, that this plan has a Enhanced Alternative benefit type.
HumanaChoice R5826-074 (Regional PPO) also provides the following benefits.
$1,300 annual deductible |
In-network | No |
$10,500 In and Out-of-network $7,550 In-network |
No |
In-network | Yes, contact plan for further details |
In-network | $0-390 copay per visit (Authorization is required.) (Referral is not required.) |
out-of-network | 50% coinsurance per visit (Authorization is required.) (Referral is not required.) |
In-network Primary | $35 copay per visit (Not applicable.) (Not applicable.) |
out-of-network Primary | 50% coinsurance per visit (Not applicable.) (Not applicable.) |
In-network Specialist | $50 copay per visit (Authorization is not required.) (Referral is not required.) |
out-of-network Specialist | 50% coinsurance per visit (Authorization is not required.) (Referral is not required.) |
In-network | $0 copay (Authorization is not required.) (Referral is not required.) |
out-of-network | $0 copay or 50% coinsurance (Authorization is not required.) (Referral is not required.) |
Emergency | $90 copay per visit (always covered) (Not applicable.) (Not applicable.) |
Urgent care | $25 copay per visit (always covered) (Not applicable.) (Not applicable.) |
In-network Diagnostic tests and procedures | $0-290 copay (Authorization is required.) (Referral is not required.) |
out-of-network Diagnostic tests and procedures | 50% coinsurance (Authorization is required.) (Referral is not required.) |
In-network Lab services | $0-50 copay (Authorization is required.) (Referral is not required.) |
out-of-network Lab services | 50% coinsurance (Authorization is required.) (Referral is not required.) |
In-network Diagnostic radiology services (e.g., MRI) | $0-350 copay (Authorization is required.) (Referral is not required.) |
out-of-network Diagnostic radiology services (e.g., MRI) | 50% coinsurance (Authorization is required.) (Referral is not required.) |
In-network Outpatient x-rays | $25-110 copay (Authorization is required.) (Referral is not required.) |
out-of-network Outpatient x-rays | 50% coinsurance (Authorization is required.) (Referral is not required.) |
In-network Hearing exam | $50 copay (Authorization is required.) (Referral is not required.) |
out-of-network Hearing exam | 50% coinsurance (Authorization is required.) (Referral is not required.) |
In-network Fitting/evaluation | $0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.) |
out-of-network Fitting/evaluation | 25% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.) |
In-network Hearing aids | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
out-of-network Hearing aids | 25% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
In-network Oral exam | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
out-of-network Oral exam | $0 copay (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 copay (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 copay (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 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.) |
In-network Diagnostic services | $0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.) |
out-of-network Diagnostic services | $0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.) |
Restorative services | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
Endodontics | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
Periodontics | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
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.) |
In-network Routine eye exam | $0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.) |
out-of-network Routine eye exam | $0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.) |
Other | Not 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 copay (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 copay (Limits may apply.) (Authorization is required.) (Referral is not 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.) |
In-network Occupational therapy visit | $10-40 copay (Authorization is required.) (Referral is not required.) |
out-of-network Occupational therapy visit | 50% coinsurance (Authorization is required.) (Referral is not required.) |
In-network Physical therapy and speech and language therapy visit | $10-40 copay (Authorization is required.) (Referral is not required.) |
out-of-network Physical therapy and speech and language therapy visit | 50% coinsurance (Authorization is required.) (Referral is not required.) |
In-network | $240 copay (Not applicable.) (Not applicable.) |
out-of-network | $240 copay (Not applicable.) (Not applicable.) |
Not covered (Not applicable.) (Not applicable.) |
In-network Foot exams and treatment | $50 copay (Authorization is required.) (Referral is not required.) |
out-of-network Foot exams and treatment | 50% coinsurance (Authorization is required.) (Referral is not required.) |
Routine foot care | Not covered (Not applicable.) (Not applicable.) |
In-network Durable medical equipment (e.g., wheelchairs, oxygen) | 20% coinsurance per item (Authorization is required.) (Not applicable.) |
out-of-network Durable medical equipment (e.g., wheelchairs, oxygen) | 30% 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) | 25% coinsurance per item (Authorization is required.) (Not applicable.) |
In-network Diabetes supplies | $0 copay or 20% coinsurance per item (Authorization is required.) (Not applicable.) |
out-of-network Diabetes supplies | 50% coinsurance per item (Authorization is required.) (Not applicable.) |
Not covered (Not applicable.) (Not applicable.) |
In-network Chemotherapy | 0-20% coinsurance (Authorization is required.) (Not applicable.) |
out-of-network Chemotherapy | 20-50% coinsurance (Authorization is required.) (Not applicable.) |
In-network Other Part B drugs | 0-20% coinsurance (Authorization is required.) (Not applicable.) |
out-of-network Other Part B drugs | 20-50% coinsurance (Authorization is required.) (Not applicable.) |
In-network Part B Insulin drugs | 0-20% coinsurance (up to $35) (Authorization is required.) (Not applicable.) |
out-of-network Part B Insulin drugs | 20-50% coinsurance (Authorization is required.) (Not applicable.) |
In-network | $625 per day for days 1 through 3 $0 per day for days 4 through 90 $0 per day for days 90 and beyond (Authorization is required.) (Referral is not required.) |
out-of-network | $725 per day for days 1 through 14 $0 per day for days 15 through 90 (Authorization is required.) (Referral is not required.) |
In-network Inpatient hospital – psychiatric | $587 per day for days 1 through 3 $0 per day for days 4 through 90 (Authorization is required.) (Referral is not required.) |
out-of-network Inpatient hospital – psychiatric | $725 per day for days 1 through 14 $0 per day for days 15 through 90 (Authorization is required.) (Referral is not required.) |
In-network Outpatient group therapy visit with a psychiatrist | $30 copay (Authorization is required.) (Referral is not required.) |
out-of-network Outpatient group therapy visit with a psychiatrist | 50% coinsurance (Authorization is required.) (Referral is not required.) |
In-network Outpatient individual therapy visit with a psychiatrist | $30 copay (Authorization is required.) (Referral is not required.) |
out-of-network Outpatient individual therapy visit with a psychiatrist | 50% coinsurance (Authorization is required.) (Referral is not required.) |
In-network Outpatient group therapy visit | $30 copay (Authorization is required.) (Referral is not required.) |
out-of-network Outpatient group therapy visit | 50% coinsurance (Authorization is required.) (Referral is not required.) |
In-network Outpatient individual therapy visit | $30 copay (Authorization is required.) (Referral is not required.) |
out-of-network Outpatient individual therapy visit | 50% coinsurance (Authorization is required.) (Referral is not required.) |
In-network | $0 per day for days 1 through 20 $167 per day for days 21 through 100 (Authorization is required.) (Referral is not required.) |
out-of-network | $250 per day for days 1 through 58 $0 per day for days 59 through 100 (Authorization is required.) (Referral is not required.) |
Ready to sign up for HumanaChoice R5826-074 (Regional PPO) ?
SMID: MULTIPLAN_HCIHNDOGMED01_M
Factsonmedicare.com is a free-to-use informational website by Dog Media Solutions LLC. All insurance agents and enrollment platforms linked to this site have their own terms and conditions.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B Premium give-back is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
All plan-related information on this site is from CMS.gov and Medicare.gov. We only use data released publicly each year. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. Contact a plan for a Summary of Benefits.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do feature in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
HealthCompare Insurance Services does not offer every plan available in your area. Currently we represent 18 organizations, which offers 52,101 products in your area.
We do not feature every plan available in your area. Any information we provide is limited to those plans we do feature in your area. Enrollment is offered through our partners including HealthCompare Insurance Services Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
HealthCompare Insurance Services represents Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.
Medicare has neither approved nor endorsed any information on this site.