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 2024 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 2024.

Locations

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

Plan Overview

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

Insurer:Humana
Health Plan Deductible:$250 annual deductible
MOOP:$5,900.00
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 insurance agent.

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

8am – 11pm EST. 7 days a week

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
$174.70 $0.00 $6.00 $168.70
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.

Health plan deductible

$250 annual deductible

Other health plan deductibles?

In-network No

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

$9,550 In and Out-of-network
$5,900 In-network

Optional supplemental benefits

Yes

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

In-network No

Outpatient hospital coverage

In-network $0-95 copay per visit (Authorization is required.) (Referral is not required.)
out-of-network 30% coinsurance per visit (Authorization is required.) (Referral is not required.)

Doctor visits

In-network Primary$10 copay per visit (Not applicable.) (Not applicable.)
out-of-network Primary30% coinsurance per visit (Not applicable.) (Not applicable.)
In-network Specialist$30 copay per visit (Authorization is not required.) (Referral is not required.)
out-of-network Specialist30% coinsurance 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 procedures30% coinsurance (Authorization is required.) (Referral is not required.)
In-network Lab services$0-60 copay (Authorization is required.) (Referral is not required.)
out-of-network Lab services30% 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)30% coinsurance (Authorization is required.) (Referral is not required.)
In-network Outpatient x-rays$10-60 copay (Authorization is required.) (Referral is not required.)
out-of-network Outpatient x-rays30% coinsurance (Authorization is required.) (Referral is not required.)

Hearing

In-network Hearing exam$30 copay (Authorization is required.) (Referral is not required.)
out-of-network Hearing exam30% coinsurance (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/evaluation50% coinsurance (There are no limits.) (Authorization is required.) (Referral is not required.)
In-network Hearing aids$399-699 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
out-of-network Hearing aids50% coinsurance (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 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.)

Comprehensive dental

In-network Non-routine services$25 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Non-routine services$25 copay or 0-50% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Diagnostic services0% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Diagnostic services$25 copay or 0-50% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Restorative services$25 copay or 50% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Restorative services$25 copay or 0-50% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Endodontics50% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Endodontics$25 copay or 0-50% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Periodontics$25 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Periodontics$25 copay or 0-50% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Extractions$25 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Extractions$25 copay or 0-50% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
In-network Prosthodontics, other oral/maxillofacial surgery, other services50% coinsurance (Limits may apply.) (Authorization is required.) (Referral is not required.)
out-of-network Prosthodontics, other oral/maxillofacial surgery, other services$25 copay or 0-50% 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 copay (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 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 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

Not covered (Not applicable.) (Not applicable.)

Foot care (podiatry services)

In-network Foot exams and treatment$30 copay (Authorization is required.) (Referral is not required.)
out-of-network Foot exams and treatment30% coinsurance (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)15% coinsurance per item (Authorization is required.) (Not applicable.)
out-of-network Durable medical equipment (e.g., wheelchairs, oxygen)20% 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 supplies30% coinsurance per item (Authorization is required.) (Not applicable.)

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

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

Medicare Part B drugs

In-network Chemotherapy0-20% coinsurance (Authorization is required.) (Not applicable.)
out-of-network Chemotherapy20-30% 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 drugs20-30% 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 drugs20-30% coinsurance (Authorization is required.) (Not applicable.)

Inpatient hospital coverage

In-network $280 per day for days 1 through 5
$0 per day for days 6 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$280 per day for days 1 through 5
$0 per day for days 6 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$30 copay (Authorization is required.) (Referral is not required.)
out-of-network Outpatient group therapy visit with a psychiatrist30% 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 psychiatrist30% 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 visit30% 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 visit30% coinsurance (Authorization is required.) (Referral is not required.)

Skilled Nursing Facility

In-network $10 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.)

Package #1

Monthly Premium$37.40
Deductiblenan

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

Get help from a licensed insurance agent.

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

8am – 11pm EST. 7 days a week

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