HumanaChoice Value H2029-001 (PPO)
$44.00
Monthly Premium
HumanaChoice Value H2029-001 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc.
Plan ID: H2029-001-000
$44.00
Monthly Premium
Puerto Rico 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 Puerto Rico 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
| Coverage | Details |
|---|---|
| Monthly plan premium | $44.00 |
| Vision coverage | |
| Dental coverage | |
| Hearing coverage | |
| Prescription drugs | |
| Medical deductible | $0.00 |
| Out-of-pocket maximum | $6,700.00 |
| Initial drug coverage limit | $0.00 |
| Catastrophic drug coverage limit | $8,000.00 |
| Primary care doctor visit | Out-of-Network: Doctor Office Visit: Coinsurance for Medicare Covered Primary Care Office Visit 20% |
| Specialty doctor visit | Out-of-Network: Doctor Specialty Visit: Coinsurance for Medicare Covered Physician Specialist Office Visit 20% |
| Inpatient hospital care | Out-of-Network: Coinsurance for Acute Hospital Services per Stay 20% |
| Urgent care | Urgent Care: Copayment for Urgent Care $15.00 Worldwide Coverage: Copayment for Worldwide Urgent Coverage $75.00 |
| Emergency room visit | Emergency Care: Copayment for Emergency Care $75.00 Copayment for Medicare Covered Emergency Care waived if you are admitted to the hospital within 24 hours Worldwide Coverage: Copayment for Worldwide Emergency Coverage $75.00 Copayment for Worldwide Emergency Transportation $75.00 |
| Ambulance transportation | In-Network: Ground Ambulance: Copayment for Ground Ambulance Services $100.00 Air Ambulance: Coinsurance for Air Ambulance Services 20% Please see Evidence of Coverage for Prior Authorization rules |
Health Care Services and Medical Supplies
HumanaChoice Value H2029-001 (PPO) covers a range of additional benefits. Learn more about HumanaChoice Value H2029-001 (PPO) benefits, some of which may not be covered by Original Medicare (Part A and Part B).
| Coverage | Details |
|---|---|
| Chiropractic services | In-Network: Chiropractic Services: Copayment for Medicare-covered Chiropractic Services $15.00 |
| Diabetes supplies, training, nutrition therapy and monitoring | Out-of-Network: Diabetic Supplies and Services: Coinsurance for Medicare Covered Diabetic Supplies and Services 20% |
| Durable medical equipment (DME) | Out-of-Network: Durable Medical Equipment: Coinsurance for Medicare Covered Durable Medical Equipment 20% |
| Diagnostic tests, lab and radiology services, and X-rays | In-Network: Outpatient Diag Procs/Tests/Lab Services: Copayment for Medicare-covered Diagnostic Procedures/Tests $0.00 to $50.00 Copayment for Medicare-covered Lab Services $0.00 Coinsurance for Medicare-covered Lab Services 10% Prior Authorization Required for Outpatient Diag Procs/Tests/Lab Services Outpatient Diag/Therapeutic Rad Services: Copayment for Medicare-covered Diagnostic Radiological Services $0.00 to $50.00 Coinsurance for Medicare-covered Therapeutic Radiological Services 10% Copayment for Medicare-covered X-Ray Services $0.00 to $15.00 Coinsurance for Medicare-covered X-Ray Services 10% Prior Authorization Required for Outpatient Diag/Therapeutic Rad Services |
| Home health care | Out-of-Network: Home Health Services: Coinsurance for Medicare Covered Home Health 20% |
| Mental health inpatient care | In-Network: Psychiatric Hospital Services: Copayment for Psychiatric Hospital Services per Stay $0.00 Prior Authorization Required for Psychiatric Hospital Services |
| Mental health outpatient care | In-Network: Outpatient Mental Health Services: Copayment for Medicare-covered Individual Sessions $8.00 Copayment for Medicare-covered Group Sessions $8.00 |
| Outpatient services/surgery | Out-of-Network: Outpatient Hospital and ASC Services: Coinsurance for Medicare Covered Outpatient Hospital Services 20% Coinsurance for Medicare Covered Ambulatory Surgical Center Services 20% |
| Outpatient substance abuse care | Out-of-Network: Outpatient Substance Abuse Services: Coinsurance for Medicare Covered Individual or Group Sessions 20% |
| Over-the-counter items | In-Network: Over-The-Counter (OTC) Items: Copayment for Over-The-Counter (OTC) Items $0.00 Maximum Plan Benefit of $20.00 every month Nicotine Replacement Therapy (NRT) offerred as a Part C OTC benefit |
| Podiatry services | Out-of-Network: Podiatry Services: Coinsurance for Medicare Covered Podiatry Services 20% |
| Skilled Nursing Facility (SNF) care | Out-of-Network: Coinsurance for Skilled Nursing Facility Services per Stay 20% |
Dental Benefits
The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Dental care | In Network: 0% coinsurance for bitewing x-rays up to 1 set(s) every 2 years. 0% coinsurance for periodontal surgery up to 1 per quadrant every 3 years. 0% coinsurance for amalgam or composite filling up to 1 per tooth every 3 years. 0% coinsurance for comprehensive oral exam, cone beam CT imaging, panoramic film up to 1 every 3 years. 0% coinsurance for crown, implant supported prosthetics up to 1 per tooth every 5 years. 0% coinsurance for bridges, complete dentures, complete or partial denture reline, partial dentures up to 1 every 5 years. 0% coinsurance for implant services, other restorative services - core buildup and prefabricated post and core up to 1 per tooth per lifetime. 0% coinsurance for scaling and root planing (deep cleaning) up to 1 per quadrant per year. 0% coinsurance for periodontal debridement up to 1 per year. 0% coinsurance for pulp vitality test up to 2 per quadrant per year. 0% coinsurance for periodic oral exam, periodontal maintenance, prophylaxis (cleaning) up to 2 per year. 0% coinsurance for complete or partial denture repair up to 3 per year. 0% coinsurance for intraoral x-rays up to 6 per year. 0% coinsurance for adjustments to dentures, extractions, root canal up to unlimited per year. $1,500 combined maximum benefit coverage amount per year for adjustments to dentures, bridges, complete dentures, complete or partial denture reline, complete or partial denture repair, crown, implant services, implant supported prosthetics, other restorative services - core buildup and prefabricated post and core, partial dentures comprehensive benefits. Out of Network: 50% coinsurance for bitewing x-rays up to 1 set(s) every 2 years. 50% coinsurance for periodontal surgery up to 1 per quadrant every 3 years. 50% coinsurance for amalgam or composite filling up to 1 per tooth every 3 years. 50% coinsurance for comprehensive oral exam, cone beam CT imaging, panoramic film up to 1 every 3 years. 50% coinsurance for crown, implant supported prosthetics up to 1 per tooth every 5 years. 50% coinsurance for bridges, complete dentures, complete or partial denture reline, partial dentures up to 1 every 5 years. 50% coinsurance for implant services, other restorative services - core buildup and prefabricated post and core up to 1 per tooth per lifetime. 50% coinsurance for scaling and root planing (deep cleaning) up to 1 per quadrant per year. 50% coinsurance for periodontal debridement up to 1 per year. 50% coinsurance for pulp vitality test up to 2 per quadrant per year. 50% coinsurance for periodic oral exam, periodontal maintenance, prophylaxis (cleaning) up to 2 per year. 50% coinsurance for complete or partial denture repair up to 3 per year. 50% coinsurance for intraoral x-rays up to 6 per year. 50% coinsurance for adjustments to dentures, extractions, root canal up to unlimited per year. $1,500 combined maximum benefit coverage amount per year for adjustments to dentures, bridges, complete dentures, complete or partial denture reline, complete or partial denture repair, crown, implant services, implant supported prosthetics, other restorative services - core buildup and prefabricated post and core, partial dentures 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.
| Coverage | Details |
|---|---|
| Vision benefits | Out-of-Network: Medicare Covered Vision Services: Coinsurance for Medicare Covered Eye Exams 20% Copayment for Medicare Covered Eyewear $0.00 Non-Medicare Covered Vision Services: Copayment for Non-Medicare Covered Eye Exams $0.00 Copayment for Non-Medicare Covered Eyewear $0.00 |
Hearing Benefits
The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Hearing benefits | Out-of-Network: Medicare Covered Hearing Services: Coinsurance for Medicare Covered Hearing Exams 20% Non-Medicare Covered Hearing Services: Copayment for Non-Medicare Covered Hearing Exams $0.00 Copayment for Non-Medicare Covered Hearing Aids $0.00 |
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.
| Coverage | Details |
|---|---|
| Preventive services and health/wellness education programs | In-Network: $0.00 copay for Medicare Covered Preventive Services: Abdominal aortic aneurysm screening Alcohol misuse screenings & counseling Bone mass measurements (bone density) Cardiovascular disease screenings Cardiovascular disease (behavioral therapy) Cervical & vaginal cancer screening Colorectal cancer screenings Depression screenings Diabetes screenings Diabetes self-management training Glaucoma tests Hepatitis B (HBV) infection screening Hepatitis C screening test HIV screening Lung cancer screening Mammograms (screening) Nutrition therapy services Obesity screenings & counseling One-time Welcome to Medicare preventive visit Prostate cancer screenings(PSA) Sexually transmitted infections screening & counseling Shots:
Yearly "Wellness" visit |
When reviewing Puerto Rico 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 Puerto Rico that offer similar benefits at similar or lower prices than the plan above. Call 1-855-298-6309 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.
Plan Documents
| Links to plan documents |
Puerto Rico Counties Served
Adjuntas
Aguada
Aguadilla
Aguas Buenas
Aibonito
Anasco
Arecibo
Arroyo
Barceloneta
Barranquitas
Bayamon
Cabo Rojo
Caguas
Camuy
Canovanas
Carolina
Catano
Cayey
Ceiba
Ciales
Cidra
Coamo
Comerio
Corozal
Culebra
Dorado
Fajardo
Florida
Guanica
Guayama
Guayanilla
Guaynabo
Gurabo
Hatillo
Hormigueros
Humacao
Isabela
Jayuya
Juana Diaz
Juncos
Lajas
Lares
Las Marias
Las Piedras
Loiza
Luquillo
Manati
Maricao
Maunabo
Mayaguez
Moca
Morovis
Naguabo
Naranjito
Orocovis
Patillas
Penuelas
Ponce
Quebradillas
Rincon
Rio Grande
Sabana Grande
Salinas
San German
San Juan
San Lorenzo
San Sebastian
Santa Isabel
Toa Alta
Toa Baja
Trujillo Alto
Utuado
Vega Alta
Vega Baja
Vieques
Villalba
Yabucoa
Yauco
We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.
