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HumanaChoice Florida H7284-001 (PPO) - H7284-001-000

na* for plan year 2025

$73.00

Monthly Premium

HumanaChoice Florida H7284-001 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc.

Plan ID: H7284-001-000

* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.

$73.00

Monthly Premium

Florida Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.

Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.

Learn more about Florida Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.

Basic Costs and Coverage

CoverageDetails
Monthly plan premium$73.00
Vision coverage
Dental coverage
Hearing coverage
Prescription drugs
Medical deductible$0.00
Out-of-pocket maximum$2,500.00
Initial drug coverage limit$0.00
Catastrophic drug coverage limit$2,000.00
Primary care doctor visitIn-Network:

Doctor Office Visit:
Copayment for Primary Care Office Visit $0
Specialty doctor visitIn-Network:

Doctor Specialty Visit:
Copayment for Physician Specialist Office Visit $20
Inpatient hospital careIn-Network:

Acute Hospital Services:
$125 per day for days 1 to 10
$0 per day for days 11 to 90
Prior Authorization Required for Acute Hospital Services
Urgent care
Urgent Care:
Copayment for Urgent Care $15

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $140
Emergency room visit
Emergency Care:
Copayment for Emergency Care $140
Copayment for Medicare Covered Emergency Care waived if you are admitted to the hospital with in 24 hours

Worldwide Coverage:
Copayment for Worldwide Emergency Coverage $140
Copayment for Worldwide Emergency Transportation $140
Ambulance transportation
Out-of-Network:

Ambulance Services:
Copayment for Medicare Covered Ambulance Services - Ground $120 to $240
Coinsurance for Medicare Covered Ambulance Services - Air 20%
$240 Ambulance Emergency - Ground Ambulance$120 Ambulance Non-Emergency - Ground Ambulance

Health Care Services and Medical Supplies

HumanaChoice Florida H7284-001 (PPO) covers a range of additional benefits. Learn more about HumanaChoice Florida H7284-001 (PPO) benefits, some of which may not be covered by Original Medicare (Part A and Part B).

CoverageDetails
Chiropractic services
Out-of-Network:

Medicare Covered Chiropractic Services:
Copayment for Medicare Covered Chiropractic Services $35
Diabetes supplies, training, nutrition therapy and monitoring
Out-of-Network:

Medicare Covered Diabetic Supplies and Services:
Coinsurance for Medicare Covered Diabetic Supplies 40%
Coinsurance for Medicare Covered Diabetic Therapeutic Shoes or Inserts 40%
Durable medical equipment (DME)
Out-of-Network:

Medicare Covered Durable Medical Equipment Services:
Coinsurance for Medicare Covered Durable Medical Equipment 20% to 50%
$0 Continuous Glucose Monitor - DME Prov$0 Continuous Glucose Monitor - Pharmacy20% DME - DME Prov20% DME - Pharmacy$0 DME-Oxygen System - DME Prov
Diagnostic tests, lab and radiology services, and X-rays
Out-of-Network:

Medicare Covered Diagnostic Procedures/Tests Services:
Copayment for Medicare Covered Diagnostic Procedures/Tests
$15 to $35
Coinsurance for Medicare Covered Diagnostic Procedures/Tests
50%
Copayment for Medicare Covered Lab Services
$15 to $35
Coinsurance for Medicare Covered Lab Services
40%
Copayment for Medicare Covered Diagnostic Radiological Services $35
Coinsurance for Medicare Covered Diagnostic Radiological Services 40%
Copayment for Medicare Covered Therapeutic Radiological Services $35
Coinsurance for Medicare Covered Therapeutic Radiological Services 40%
Copayment for Medicare Covered Outpatient X-Ray Services $15 to $35
Coinsurance for Medicare Covered Outpatient X-Ray Services 40%
$50 OP Diag Proc & Tests - OPH$0 OP Diag Proc & Tests - PCP$20 OP Diag Proc & Tests - SPC$15 OP Diag Proc & Tests - UCC$125 Sleep Study (Fac Based) - OPH$125 Sleep Study (Fac Based) - SPC$0 Sleep Study (Home Based) - Mbr's Home
Home health care
Out-of-Network:

Medicare Covered Home Health Services:
Coinsurance for Medicare Covered Home Health 50%
Mental health inpatient care
Out-of-Network:

Psychiatric Hospital Services:
Coinsurance for Psychiatric Hospital per Stay 40%
Mental health outpatient care
Out-of-Network:

Medicare Covered Mental Health Services:
Copayment for Medicare Covered Individual Sessions $35
Copayment for Medicare Covered Group Sessions $35
Outpatient services/surgery
Out-of-Network:

Medicare Covered Outpatient Hospital Services:
Copayment for Medicare Covered Outpatient Hospital Services $35
Coinsurance for Medicare Covered Outpatient Hospital Services 40%
Coinsurance for Medicare Covered Ambulatory Surgical Center Services 40%
$0 Diag Colonoscopy - OPH$50 Mental Health - OPH$125 Surgery Svcs - OPH$20 Wound Care - OPH
Outpatient substance abuse care
Out-of-Network:

Medicare Covered Outpatient Substance Abuse Services:
Copayment for Medicare Covered Individual Sessions $35
Coinsurance for Medicare Covered Individual Sessions 40%
Copayment for Medicare Covered Group Sessions $35
Coinsurance for Medicare Covered Group Sessions 40%
$50 OP Substance Abuse Care - OPH$20 OP Substance Abuse Care - SPC
Podiatry services
Out-of-Network:

Medicare Covered Podiatry Services:
Copayment for Medicare Covered Podiatry Services $35
Skilled Nursing Facility (SNF) careIn-Network:

Skilled Nursing Facility Services:
$0 per day for days 1 to 20
$160 per day for days 21 to 100
Prior Authorization Required for Skilled Nursing Facility Services

Dental Benefits

The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Dental care0% coinsurance for comprehensive oral evaluation or periodontal exam up to 1 every 3 years.
0% coinsurance for panoramic film or diagnostic x-rays up to 1 every 5 years.
0% coinsurance for bitewing x-rays, intraoral x-rays up to 1 set(s) per year.
0% coinsurance for emergency diagnostic exam up to 1 per year.
0% coinsurance for periodic oral exam, prophylaxis (cleaning) up to 2 per year.
0% coinsurance for periodontal maintenance up to 4 per year.
0% coinsurance for necessary anesthesia with covered service up to unlimited per year.
$25 copayment for scaling and root planing (deep cleaning) up to 1 per quadrant every 3 years.
$25 copayment for scaling for moderate inflammation up to 1 every 3 years.
$25 copayment per tooth for amalgam and/or composite filling up to unlimited per year.
$1,000 combined maximum benefit coverage amount per year for all diagnostic/preventive and comprehensive benefits.
Out of Network
0% coinsurance for comprehensive oral evaluation or periodontal exam up to 1 every 3 years.
0% coinsurance for panoramic film or diagnostic x-rays up to 1 every 5 years.
0% coinsurance for bitewing x-rays, intraoral x-rays up to 1 set(s) per year.
0% coinsurance for emergency diagnostic exam up to 1 per year.
0% coinsurance for periodic oral exam, prophylaxis (cleaning) up to 2 per year.
0% coinsurance for periodontal maintenance up to 4 per year.
0% coinsurance for necessary anesthesia with covered service up to unlimited per year.
$25 copayment for scaling and root planing (deep cleaning) up to 1 per quadrant every 3 years.
$25 copayment for scaling for moderate inflammation up to 1 every 3 years.
$25 copayment per tooth for amalgam and/or composite filling up to unlimited per year.
$1,000 combined maximum benefit coverage amount per year for all diagnostic/preventive and comprehensive benefits.
Benefits received out-of-network are subject to any in-network benefit maximums, limitations, and/or exclusions.

Vision Benefits

The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage

CoverageDetails
Vision careIn-Network:

Eye Exams:
Copayment for Medicare Covered Benefits $0 to $20
Copayment for Routine Eye Exams $0
  • Maximum 1 Routine Eye Exam every year
Maximum Plan Benefit of $75 every year

Eyewear:
Copayment for Medicare-Covered Benefits $0
Copayment for Contact Lenses $0
  • Maximum 1 Pair every year
Copayment for Eyeglasses (lenses and frames) $0
  • Maximum 1 Pair every year
Maximum Plan Benefit of $200 every year
Members must use Humana's Medicare Insight Network, a national network of providers, which includes standard or PLUS providers. The allowance for the standard network is $50 less than the PLUS network.

Hearing Benefits

The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Hearing careIn-Network:

Hearing Exams:
Copayment for Medicare Covered Benefits $20
Copayment for Routine Hearing Exams $0
  • Maximum 1 visit every year
Copayment for Fitting/Evaluation for Hearing Aid $0
  • Maximum 1 visit every year
Prior Authorization Required for Hearing Exams

Hearing Aids:
Copayment for Hearing Aids $0
  • Maximum 2 Hearing Aids every three years
Maximum Plan Benefit of $1,000 every three years

Preventive Services and Health/Wellness Education Programs

The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Preventive services and health/wellness education programs
Out-of-Network:

Medicare Covered Medicare-covered Preventive Services:
Copayment for Medicare Covered Medicare-covered Preventive Services $0
Coinsurance for Medicare Covered Medicare-covered Preventive Services 50%

When reviewing Florida Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.

You may be able to find plans in your part of Florida that offer similar benefits at similar or lower prices than the plan above. Call 1-800-557-6059 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.

Plan Documents

Links to plan documents

Florida Counties Served

We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield*, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

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