In-Network Cost
HumanaChoice H5216-048 (PPO)
Local PPO
Humana
Monthly Premium
$118.00
Part C
$52.00
Part D
$66.00
Out-of-Pocket Max
$6,700.00
/yr
Key Benefits at a Glance
Dental Up to
/yr
Vision
$0
eyewear allowance
Hearing
/yr hearing aids
OTC
/quarter credit
Transport
rides/year
Fitness
SilverSneakers
Meals After Hosp
{meal benefit}
Overall Rating
Part C Rating
Part D Rating
Where Is This Plan Available?
Available in
23
counties:
Also available in these cities:
Plan Benefits —
Copays & Cost Sharing
Benefit
Primary Care Visit
$0 copay
Specialist Visit
$30 copay
Emergency Room
$95 copay
Urgent Care
$25 copay
Hospital Inpatient (day 1-5)
$325 copay per day for days 1-4 30% of the cost
Mental Health Outpatient
$265 copay
Telehealth
$0 copay
Preventive Visit
$0 copay
Drug Formulary Tiers
Tier
Drug Type
30-Day Retail
90-Day Mail
1
Generic drugs
25%
25%
2
Preferred brand
25%
25%
3
Standard brand
24%
24%
4
Non-preferred
25%
25%
5
Specialty drugs
25%
Compare This Plan Side by Side
See all Carrier PlansMedicare Questions About
Medicare Advantage PPO
Plans
What happens if I need care at a hospital that is out of my Medicare Advantage network?
Which Utah D-SNP plans are available in my area?
Which Medicare Advantage plans include Intermountain hospitals?
How often do Medicare Advantage provider networks change?
What if my doctors stop taking my plan?
Does Medicare Advantage require prior authorization, and for what services?
Understanding
Medicare Advantage PPO
A Medicare Advantage PPO lets you see any Medicare-approved doctor or specialist without a referral. You save money by staying in the plan's preferred network, but you still have coverage if you go out of network. PPOs are popular with people who travel frequently or want to keep a specific doctor who may not be in an HMO network.
HMO vs PPO — Which Is Right for You?
Not sure if this plan is right for you?
Peter Abilla is a licensed Utah Medicare agent. He can walk you through this plan's costs, coverage, and whether your doctors are in-network.