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HumanaChoice R7315-001 (Regional PPO)

R7315 - 001 - 0
3.5 out of 5 stars (3.5 / 5)

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HumanaChoice R7315-001 (Regional PPO) is a Medicare Advantage (Part C) Plan by Humana.

This page features plan details for 2023 HumanaChoice R7315-001 (Regional PPO) R7315 – 001 – 0 available in States of Alabama and Tennessee.

IMPORTANT: This page has been updated with plan and premium data for 2023.

Locations

HumanaChoice R7315-001 (Regional PPO) is offered in the following locations.

Alabama
Anderson County, Tennessee
Autauga County, Alabama

Click to see more locations

Plan Overview

HumanaChoice R7315-001 (Regional PPO) offers the following coverage and cost-sharing.

Insurer:Humana
Health Plan Deductible:$250 annual deductible
MOOP:$5,100 In and Out-of-network
$3,400 In-network
Drugs Covered:No
Please Note:
  • This plan's deductible only applies to out-of-network services.

Ready to sign up for HumanaChoice R7315-001 (Regional PPO) ?

Get help from a licensed Medicare agent.

Click to Call 1-877-354-4611 TTY 711. Mon-Fri 8am-9pm EST | Sat 8am-8pm 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. 

HumanaChoice R7315-001 (Regional PPO) qualifies for a monthly Medicare Give Back Benefit of $6.00.

Premium Reduction:$6.00

Premium Breakdown

HumanaChoice R7315-001 (Regional 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
$164.90 $0.00 $6.00 $158.90
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.

Additional Benefits

HumanaChoice R7315-001 (Regional PPO) also provides the following benefits.

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

In-Network: No

Dental (comprehensive)

Diagnostic services:In-Network: 0% coinsurance (limits may apply) (authorization required) (referral not required)
Diagnostic services:Out-of-Network: 50-75% coinsurance (limits may apply) (authorization required) (referral not required)
Endodontics:In-Network: 70% coinsurance (limits may apply) (authorization required) (referral not required)
Endodontics:Out-of-Network: 50-75% coinsurance (limits may apply) (authorization required) (referral not required)
Extractions:In-Network: 50% coinsurance (limits may apply) (authorization required) (referral not required)
Extractions:Out-of-Network: 50-75% coinsurance (limits may apply) (authorization required) (referral not required)
Non-routine services:In-Network: 50% coinsurance (limits may apply) (authorization required) (referral not required)
Non-routine services:Out-of-Network: 50-75% coinsurance (limits may apply) (authorization required) (referral not required)
Periodontics:In-Network: 70% coinsurance (limits may apply) (authorization required) (referral not required)
Periodontics:Out-of-Network: 50-75% coinsurance (limits may apply) (authorization required) (referral not required)
Prosthodontics, other oral/maxillofacial surgery, other services:In-Network: 70% coinsurance (limits may apply) (authorization required) (referral not required)
Prosthodontics, other oral/maxillofacial surgery, other services:Out-of-Network: 50-75% coinsurance (limits may apply) (authorization required) (referral not required)
Restorative services:In-Network: 50-70% coinsurance (limits may apply) (authorization required) (referral not required)
Restorative services:Out-of-Network: 50-75% coinsurance (limits may apply) (authorization required) (referral not required)

Dental (preventive)

Cleaning:In-Network: 0-70% coinsurance (limits may apply) (authorization not required) (referral not required)
Cleaning:Out-of-Network: 50-75% coinsurance (limits may apply) (authorization not required) (referral not required)
Dental x-ray(s):In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Dental x-ray(s):Out-of-Network: 50-75% coinsurance (limits may apply) (authorization not required) (referral not required)
Fluoride treatment:In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Fluoride treatment:Out-of-Network: 50-75% coinsurance (limits may apply) (authorization not required) (referral not required)
Oral exam:In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Oral exam:Out-of-Network: 50-75% coinsurance (limits may apply) (authorization not required) (referral not required)

Diagnostic procedures/lab services/imaging

Diagnostic radiology services (e.g., MRI):In-Network: $0-150 copay (authorization required) (referral not required)
Diagnostic radiology services (e.g., MRI):Out-of-Network: 30% coinsurance (authorization required) (referral not required)
Diagnostic tests and procedures:In-Network: $0-50 copay (authorization required) (referral not required)
Diagnostic tests and procedures:Out-of-Network: 30% coinsurance (authorization required) (referral not required)
Lab services:In-Network: $0-40 copay (authorization required) (referral not required)
Lab services:Out-of-Network: 30% coinsurance (authorization required) (referral not required)
Outpatient x-rays:In-Network: $10-50 copay (authorization required) (referral not required)
Outpatient x-rays:Out-of-Network: 30% coinsurance (authorization required) (referral not required)

Doctor visits

Primary:In-Network: $10 copay per visit
Primary:Out-of-Network: 30% coinsurance per visit
Specialist:In-Network: $30 copay per visit (authorization not required) (referral not required)
Specialist:Out-of-Network: 30% coinsurance per visit (authorization not required) (referral not required)

Emergency care/Urgent care

Emergency: $125 copay per visit (always covered)
Urgent care: $30 copay per visit (always covered)

Foot care (podiatry services)

Foot exams and treatment:In-Network: $30 copay (authorization required) (referral not required)
Foot exams and treatment:Out-of-Network: 30% coinsurance (authorization required) (referral not required)
Routine foot care: Not covered

Ground ambulance

In-Network: $300 copay
Out-of-Network: $300 copay

Health plan deductible

$250 annual deductible

Health plan deductibles (other)

In-Network: No

Hearing

Fitting/evaluation:In-Network: $0 copay (no limits) (authorization required) (referral not required)
Fitting/evaluation:Out-of-Network: $0 copay (no limits) (authorization required) (referral not required)
Hearing aids:In-Network: $399-699 copay (limits may apply) (authorization not required) (referral not required)
Hearing aids:Out-of-Network: $399-699 copay (limits may apply) (authorization not required) (referral not required)
Hearing exam:In-Network: $30 copay (authorization required) (referral not required)
Hearing exam:Out-of-Network: 30% coinsurance (authorization required) (referral not required)

Hospital coverage (inpatient)

In-Network: $550 per stay (authorization required) (referral not required)
Out-of-Network: 30% per stay (authorization required) (referral not required)

Hospital coverage (outpatient)

In-Network: $0-95 copay per visit (authorization required) (referral not required)
Out-of-Network: 30% coinsurance per visit (authorization required) (referral not required)

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

$5,100 In and Out-of-network
$3,400 In-network

Medical equipment/supplies

Diabetes supplies:In-Network: $0 copay or 10-20% coinsurance per item (authorization required)
Diabetes supplies:Out-of-Network: 30% coinsurance per item (authorization required)
Durable medical equipment (e.g., wheelchairs, oxygen):In-Network: 15% coinsurance per item (authorization required)
Durable medical equipment (e.g., wheelchairs, oxygen):Out-of-Network: 20% coinsurance per item (authorization required)
Prosthetics (e.g., braces, artificial limbs):In-Network: 20% coinsurance per item (authorization required)
Prosthetics (e.g., braces, artificial limbs):Out-of-Network: 30% coinsurance per item (authorization required)

Medicare Part B drugs

Chemotherapy:In-Network: 20% coinsurance (authorization required)
Chemotherapy:Out-of-Network: 20-30% coinsurance (authorization required)
Other Part B drugs:In-Network: 20% coinsurance (authorization required)
Other Part B drugs:Out-of-Network: 20-30% coinsurance (authorization required)

Mental health services

Inpatient hospital – psychiatric:In-Network: $550 per stay (authorization required) (referral not required)
Inpatient hospital – psychiatric:Out-of-Network: 30% per stay (authorization required) (referral not required)
Outpatient group therapy visit:In-Network: $30 copay (authorization required) (referral not required)
Outpatient group therapy visit:Out-of-Network: 30% coinsurance (authorization required) (referral not required)
Outpatient group therapy visit with a psychiatrist:In-Network: $30 copay (authorization required) (referral not required)
Outpatient group therapy visit with a psychiatrist:Out-of-Network: 30% coinsurance (authorization required) (referral not required)
Outpatient individual therapy visit:In-Network: $30 copay (authorization required) (referral not required)
Outpatient individual therapy visit:Out-of-Network: 30% coinsurance (authorization required) (referral not required)
Outpatient individual therapy visit with a psychiatrist:In-Network: $30 copay (authorization required) (referral not required)
Outpatient individual therapy visit with a psychiatrist:Out-of-Network: 30% coinsurance (authorization required) (referral not required)

Optional supplemental benefits

No

Preventive care

In-Network: $0 copay (authorization not required) (referral not required)
Out-of-Network: $0 copay or 30% coinsurance (authorization not required) (referral not required)

Rehabilitation services

Occupational therapy visit:In-Network: $20 copay (authorization required) (referral not required)
Occupational therapy visit:Out-of-Network: 30% coinsurance (authorization required) (referral not required)
Physical therapy and speech and language therapy visit:In-Network: $20 copay (authorization required) (referral not required)
Physical therapy and speech and language therapy visit:Out-of-Network: 30% coinsurance (authorization required) (referral not required)

Skilled Nursing Facility

In-Network: $0 per day for days 1 through 20
$196 per day for days 21 through 100 (authorization required) (referral not required)
Out-of-Network: 30% per stay (authorization required) (referral not required)

Transportation

Not covered

Vision

Contact lenses:In-Network: $0 copay (limits may apply) (authorization required) (referral not required)
Contact lenses:Out-of-Network: $0 copay (limits may apply) (authorization required) (referral not required)
Eyeglass frames: Not covered (no limits)
Eyeglass lenses: Not covered (no limits)
Eyeglasses (frames and lenses):In-Network: $0 copay (limits may apply) (authorization required) (referral not required)
Eyeglasses (frames and lenses):Out-of-Network: $0 copay (limits may apply) (authorization required) (referral not required)
Other: Not covered (no limits)
Routine eye exam:In-Network: $0 copay (limits may apply) (authorization required) (referral not required)
Routine eye exam:Out-of-Network: $0 copay (limits may apply) (authorization required) (referral not required)
Upgrades: Not covered

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

Covered (authorization not required) (referral not required)

Ready to sign up for HumanaChoice R7315-001 (Regional PPO) ?

Get help from a licensed Medicare agent.

Click to Call 1-877-354-4611 TTY 711. Mon-Fri 8am-9pm EST | Sat 8am-8pm EST.

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